Severity of Liver Injury and Its Relation to Clinical Outcome and Duration of Hospitalization in COVID 19 Patients

Cokorde Istri Yuliandari Krisnawardani Kumbara(1), I Ketut Mariadi(2), Gde Somayana(3), I Dewa Nyoman Wibawa(4), Dwijo Anargha Sindhughosa(5),


(1) Department of Internal Medicine, Faculty of Medicine of Udayana University, Udayana University Hospital, Badung, Bali, Indonesia
(2) Division of Gastroenterohepatology, Department of Internal Medicine, Faculty of Medicine of Udayana University / Prof. Dr. I.G.N.G. Ngoerah Hospital, Denpasar, Bali, Indonesia
(3) Division of Gastroenterohepatology, Department of Internal Medicine, Faculty of Medicine of Udayana University / Prof. Dr. I.G.N.G. Ngoerah Hospital, Denpasar, Bali, Indonesia
(4) Department of Internal Medicine and Endoscopy Unit, BaliMed Hospital, Denpasar, Bali, Indonesia
(5) Division of Gastroenterohepatology, Department of Internal Medicine, Faculty of Medicine of Udayana University / Prof. Dr. I.G.N.G. Ngoerah Hospital, Denpasar, Bali, Indonesia
Corresponding Author

Abstract


Background: Coronavirus Disease 2019 (COVID-19) can affect not only the respiratory system but also other organs such as the liver. Liver injury tends to occur in severe disease of COVID-19 patients and might contribute to clinical outcomes for patients. This study aimed to find the relationship between the severity of liver injury with clinical outcome and duration of hospitalizations.

Methods: This study was a retrospective study of hospitalized COVID-19 patients period April 2020 to April 2021. The inclusion criteria were severe COVID-19 patients who developed a liver injury. The severity of the liver injury was classified into mild, moderate, and severe. The relationship between the severity of liver injury with clinical outcome and duration of hospitalization was analyzed. Univariate and logistic regression were used.

Results: 90 samples fill the inclusion criteria. The liver injury severity was statistically significantly related to clinical outcome patients (p= 0.047), which is the increase in liver injury severity resulting in poor clinical outcomes. No significant relationship was found between the severity of liver injury with the duration of hospitalization.

Conclusion: liver injury increases mortality in severe COVID-19 patients.


Keywords


COVID-19; clinical outcome; duration of hospitalization; liver injury

References


Okediji PT, Ojo AS, Akin-Onitolo AP. A review of the extrapulmonary manifestations of the 2019 novel coronavirus disease (COVID-19). J Contemp Stud Epidemiol Public Heal 2020;1(2):ep20008.

Nardo AD, Schneeweiss-Gleixner M, Bakail M, Dixon ED, Lax SF, Trauner M. Pathophysiological mechanisms of liver injury in COVID-19. Liver Int 2021;41(1):20-32.

Jiang S, Wang R, Li L, Hong D, Ru R, Rao Y, et al. Liver injury in critically ill and non-critically ill COVID-19pPatients: A multicenter, retrospective, observational study. Front Med 2020;7:1–10.

Ali N, Hossain K. Liver injury in severe COVID-19 infection: current insights and challenges. Expert Rev Gastroenterol Hepatol 2020;14(10):879–84.

Amit M, Sorkin A, Chen J, Cohen B, Karol D, Tsur AM, et al. Clinical course and outcomes of severe Covid-19: A national scale study. J Clin Med 2020;9(7):2282.

WHO Headquarters. Clinical Management of COVID-19: Living Guidance. World Heal Organ [Internet]. 2021;(January). Available from: https://www.who.int/publications/i/item/WHO-2019-nCoV-clinical-2021-1

Wang Q, Zhao H, Liu LG, Wang YB, Zhang T, Li MH, et al. The pattern of liver injury in adult patients with COVID-19: a retrospective analysis of 105 patients. Military Medical Research 2020;7(1):28.

Wu Y, Li H, Guo X, Yoshida EM, Mendez-Sanchez N, Levi Sandri GB, et al. Incidence, risk factors, and prognosis of abnormal liver biochemical tests in COVID-19 patients: a systematic review and meta-analysis. Hepatol Int 2020;14(5):621-37.

Taramasso L, Vena A, Bovis F, Portunato F, Mora S, Dentone C, et al. Higher mortality and intensive care unit admissions in COVID-19 patients with liver enzyme elevations. Microorganisms 2020;8(12):2010.

Faico-Filho KS, Passarelli VC, Bellei N. Is higher viral load in SARS-CoV-2 associated with death?. Am. J. Trop. Med. Hyg 2020;103(5):2019–21.

Wong GL, Yip TC, Wong VW, Tse YK, Hui DS, Lee SS, et al. SARS-CoV-2 viral persistence based on cycle threshold value and liver injury in patients with COVID-19. Open Forum Infect Dis 2021;8(6):ofab205.

Yang Z, Xu M, Yi JQ, Jia WD. Clinical characteristics and mechanism of liver damage in patients with severe acute respiratory syndrome. Hepatobiliary Pancreat Dis Int 2005;4(1):60–3.

Hamming I, Timens W, Bulthuis ML, Lely AT, Navis G, van Goor H. Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. A first step in understanding SARS pathogenesis. J Pathol 2004;203(2):631–7.

Kumar P, Sharma M, Kulkarni A, Rao PN. Pathogenesis of liver injury in coronavirus disease. J Clin Exp Hepatol 2019;10(6):641–2.

Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395(10223):497–506.

Ma GG, Shen YX, Wu L, Luo Z, Zhu CW, Chen SY, et al. Effect of liver injury on prognosis and treatment of hospitalized patients with COVID-19 pneumonia. Ann Transl Med 2021;9(1):10.


Full Text: PDF

Article Metrics

Abstract View : 47 times
PDF Download : 26 times

DOI: 10.24871/251202447-52

Refbacks

  • There are currently no refbacks.