In:
PLOS ONE, Public Library of Science (PLoS), Vol. 18, No. 9 ( 2023-9-13), p. e0277859-
Abstract:
Using a large dataset, we evaluated prevalence and severity of alterations in liver enzymes in COVID-19 and association with patient-centred outcomes. Methods We included hospitalized patients with confirmed or suspected SARS-CoV-2 infection from the International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) database. Key exposure was baseline liver enzymes (AST, ALT, bilirubin). Patients were assigned Liver Injury Classification score based on 3 components of enzymes at admission: Normal; Stage I) Liver injury: any component between 1-3x upper limit of normal (ULN); Stage II) Severe liver injury: any component ≥3x ULN. Outcomes were hospital mortality, utilization of selected resources, complications, and durations of hospital and ICU stay. Analyses used logistic regression with associations expressed as adjusted odds ratios (OR) with 95% confidence intervals (CI). Results Of 17,531 included patients, 46.2% (8099) and 8.2% (1430) of patients had stage 1 and 2 liver injury respectively. Compared to normal, stages 1 and 2 were associated with higher odds of mortality (OR 1.53 [1.37–1.71]; OR 2.50 [2.10–2.96] ), ICU admission (OR 1.63 [1.48–1.79]; OR 1.90 [1.62–2.23] ), and invasive mechanical ventilation (OR 1.43 [1.27–1.70]; OR 1.95 (1.55–2.45). Stages 1 and 2 were also associated with higher odds of developing sepsis (OR 1.38 [1.27–1.50] ; OR 1.46 [1.25–1.70]), acute kidney injury (OR 1.13 [1.00–1.27] ; OR 1.59 [1.32–1.91]), and acute respiratory distress syndrome (OR 1.38 [1.22–1.55] ; OR 1.80 [1.49–2.17]). Conclusions Liver enzyme abnormalities are common among COVID-19 patients and associated with worse outcomes.
Type of Medium:
Online Resource
ISSN:
1932-6203
DOI:
10.1371/journal.pone.0277859
DOI:
10.1371/journal.pone.0277859.t001
DOI:
10.1371/journal.pone.0277859.t002
DOI:
10.1371/journal.pone.0277859.t003
DOI:
10.1371/journal.pone.0277859.t004
DOI:
10.1371/journal.pone.0277859.t005
DOI:
10.1371/journal.pone.0277859.s001
DOI:
10.1371/journal.pone.0277859.s002
DOI:
10.1371/journal.pone.0277859.s003
DOI:
10.1371/journal.pone.0277859.s004
DOI:
10.1371/journal.pone.0277859.s005
DOI:
10.1371/journal.pone.0277859.s006
DOI:
10.1371/journal.pone.0277859.s007
DOI:
10.1371/journal.pone.0277859.s008
DOI:
10.1371/journal.pone.0277859.r001
DOI:
10.1371/journal.pone.0277859.r002
DOI:
10.1371/journal.pone.0277859.r003
DOI:
10.1371/journal.pone.0277859.r004
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2023
detail.hit.zdb_id:
2267670-3
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