Hepatic Involvement and Association with Prognosis in COVID-19 Patients: A Single-Centre Report from Iran
Novelty in Biomedicine,
Vol. 9 No. 4 (2021),
12 November 2021
,
Page 171-177
https://doi.org/10.22037/nbm.v9i4.33947
Abstract
Background:There were no documents about the non-lung involvement of COVID-19, even in the absence of lung involvement. The present study aimed to report a single-centre experience of liver involvement caused by COVID-19 disease in Iran.MaterialsandMethods:We recorded information of 120 patients who suffered COVID-19 disease, and they were admitted to the intensive care unit at Taleghani hospital in Tehran, Iran, between March and May 2020. Along with clinical and diagnostic parameters, the outcome of patients concerning improvement, disease progression or death was also assessed.
Results:In total, 68 patients (56.7%) had abnormal liver dysfunction. The most common changes in liver-related parameters were elevated international normalized ratio (INR) (mean serum level of 2.5) followed by elevated alkaline phosphatase (ALP) (mean serum level of 412 mg/dl). The mean level of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) increased 4 and 9 times more than the standard limit. The overall death rate in COVID-19 patients was 38 patients (55.88%, n=68).
Conclusion:Liver injuries are common findings in patients suffering COVID-19 infection and leading to poorer outcomes. Serum bilirubin level of more than 3mg/dl was associated with higher mortality in patients with liver damage.
- COVID-19, Liver injury, Liver aminotransferase, SARS-COV-2
How to Cite
References
World Health Organization website. Novel coronavirus: China. www.who.int/csr/don/12-january-2020-novel-coronavirus-china/en/. Published January 12, 2020.
Ren LL, Wang YM, Wu ZQ, et al. Identification of a novel coronavirus causing severe pneumonia in human: a descriptive study. Chin Med J. 2020.
World Health Organization website. Naming the coronavirus disease (COVID-2019) and the virus that causes it. www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/naming-the-coronavirus-disease-(covid-2019)-and-the-virus-that-causes-it.
China National Health Commission website. Update on the novel coronavirus pneumonia outbreak as of 24:00 on February 17. www.nhc.gov.cn/xcs/yqtb/202002/261f72a74be14c4db6e1b582133cf4b7.shtml.
World Health Organization website. Novel corona-virus: Thailand (ex-China). www.who.int/csr/don/14-january-2020-novel-coronavirus-thailand/en/. Published January 14, 2020.
World Health Organization website. Novel corona-virus: Japan (ex-China). www.who.int/csr/don/16-january-2020-novel-coronavirus-japan-ex-china/en/. Published January 16, 2020.
World Health Organization website. Novel coronavirus: Republic of Korea (ex-China). www.who.int/csr/don/21-january-2020-novel-coronavirus-republic-of-korea-ex-china/en/. Published January 21, 2020.
U.S. Centres for Disease Control and Prevention website. First travel-related case of 2019 novel coronavirus detected in United States. www.cdc.gov/media/releases/2020/p0121-novel-coronavirus-travel-case.html. Published January 21, 2020.
World Health Organization website. Statement on the second meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of novel coronavirus (2019-nCoV). www.who.int/news-room. Published January 30, 2020.
Ksiazek TG, Erdman D, Goldsmith CS, et al.; SARS Working Group. A novel coronavirus associated with severe acute respiratory syndrome. N Engel J Med. 2003;348:1953–66.
Dorsten C, Günther S, Presser W, et al. Identification of a novel coronavirus in patients with severe acute respiratory syndrome. N Engl J Med. 2003;348:1967–76.
Zaki AM, van Boheemen S, Bestebroer TM, Osterhaus AD, Fouchier RA. Isolation of a novel coronavirus from a man with pneumonia in Saudi Arabia. N Engl J Med. 2012;367:1814–20.
de Groot RJ, Baker SC, Baric RS, et al. Middle East respiratory syndrome coronavirus (MERS-CoV): announcement of the Coronavirus Study Group. J Virol. 2013;87:7790–2.
Chan JF, Yuan S, Koch KH, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet. 2020;395:514–23.
Phan LT, Nguyen TV, Luong QC, et al. Importation and human-to-human transmission of a novel coronavirus in Vietnam. N Engl J Med. 2020.
Li Q, Guan X, Wu P, et al. Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N Engl J Med. 2020.
Singhal T. A Review of Coronavirus Disease-2019 (COVID-19). Indian J Pediatr. 2020 Apr;87(4):281-286. doi: 10.1007/s12098-020-03263-6. Epub 2020 Mar 13.
Zhang C, Shi L, Wang FS. Liver injury in COVID-19: management and challenges. Lancet Gastroenterol Hepatol. 2020 ;5(5):428-30.
Feng G, Zheng KI, Yan QQ, Rios RS, Targher G, Byrne CD, et al. COVID-19 and Liver Dysfunction: Current Insights and Emergent Therapeutic Strategies. J Clin Transl Hepatol. 2020;8(1):18-24.
Lee IC, Huo T, Huang YH. Gastrointestinal and Liver Manifestations in Patients with COVID-19. J Chin Med Assoc. 2020.
Chen Y, Li T, Ye Y, Chen Y, Pan J. Impact of fundamental diseases on patients with COVID-19. Disaster Med Public Health Prep. 2020;1-15.
Zhu J, Zhong Z, Ji P, Li H, Li B, Pang J, Zhang J, Zhao C. Clinicopathological characteristics of 8697 patients with COVID-19 in China: a meta-analysis. Fam Med Community Health. 2020;8(2).
Chen P, Zhou B. Clinical characteristics of COVID-19 patients with abnormal liver tests. J Hepatol. 2020;8(20):30272-5.
Boeckmans J, Rodrigues RM, Demuyser T, Piérard D, Vanhaecke T, Rogiers V. COVID-19 and drug-induced liver injury: a problem of plenty or a petty point? Arch Toxicol. 2020 Apr 8. doi: 10.1007/s00204-020-02734-1.
Wander P, Epstein M, Bernstein D. COVID-19 Presenting as Acute Hepatitis. Am J Gastroenterol. 2020 Apr 15. doi: 10.14309/ajg.0000000000000660.
Yeo C, Kaushal S, Yeo D. Enteric involvement of coronaviruses: is faecal-oral transmission of SARS-CoV-2 possible? Lancet Gastroenterol Hepatol. 2020;5(4):335-7.
Li MY, Li L, Zhang Y, Wang XS. Expression of the SARS-CoV-2 cell receptor gene ACE2 in a wide variety of human tissues. Infect Dis Poverty. 2020;9(1):45.
Cheng H, Wang Y, Wang GQ. Organ-protective effect of angiotensin-converting enzyme 2 and its effect on the prognosis of COVID-19. J Med Virol. 2020.
Henry BM, de Oliveira MHS, Benoit S, Plebani M, Lippi G. Hematologic, biochemical and immune biomarker abnormalities associated with severe illness and mortality in coronavirus disease 2019 (COVID-19): a meta-analysis. Clin Chem Lab Med. 2020 Apr 10. pii: /j/cclm.ahead-of-print/cclm-2020-0369/cclm-2020-0369.xml. doi: 10.1515/cclm-2020-0369.
Guan W-J, Ni Z-Y, Hu Y, et al. Clinical characteristics of 2019 novel coronavirus infection in China. N Engl J Med 2020. DOI:10.1056/NEJMoa2002032
Huang C, Wang Y, Li X. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497–506.
Chen N, Zhou M, Dong X. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395:507–13.
Wang D, Hu B, Hu C. Clinical characteristics of 138 hospitalised patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA. 2020 doi: 10.1001/jama.2020.1585.
Shi H, Han X, Jiang N. Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study. Lancet Infect Dis. 2020 doi: 10.1016/S1473-3099(20)30086-4.
Xu X-W, Wu X-X, Jiang X-G. Clinical findings in a group of patients infected with the 2019 novel coronavirus (SARS-Cov-2) outside of Wuhan, China: retrospective case series. BMJ. 2020 doi: 10.1136/bmj.m606. published online Feb 19.
Yang X, Yu Y, Xu J. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med. 2020 doi: 10.1016/S2213-2600(20)30079-5.
Parohan M, Yaghoubi S, Seraj A. Liver injury is associated with severe Coronavirus disease 2019 (COVID-19) infection: a systematic review and meta-analysis of retrospective studies. Hepatol Res. 2020 May 9. doi: 10.1111/hepr.13510.
- Abstract Viewed: 87 times
- pdf Downloaded: 83 times