Results
Between the 9th of March and the
10th of June, 444 patients were hospitalized in the
COVID-19 treatment wards (including a specialized COVID-19 care ICU).
After the application of exclusion criteria (lack of baseline LFTs in
previous year, lack of medical information in medical file or history of
known hepatic disease), the final study cohort consisted of 133 patients
(figure 1).
The characteristics of the study cohort are outlined in table 1 below.
The mean age of the cohort subjects was 65.7 ± 22.1 years and the mean
BMI was 28.7 ± 13.0. Seventy-three were males (54.9%). The most
frequently reported co-morbidities were Dyslipidemia and hypertension
(64.6% and 45.1%, respectively). The mean baseline AST and ALT levels
were
28.4 ± 21.9 and 25.7 ± 30.2, respectively. The most commonly used
chronic medications were ASA (15%) and statins (36.1%).
Subjects in the study cohort were then classified based on their LFTs
into 2 groups; a group with abnormal baseline LFTs that consisted on 50
subjects and a group of normal baselines LFTs that included 83 patients.
The two groups were then compared with respect to their demographic,
clinical characteristics, mean LFTs values and outcomes observed during
hospitalization. No statistically significant differences were noted
between the two groups with respect to baseline demographic and
co-morbidities, but subjects with abnormal LFTs were more likely to die
(22% versus 4.8%, p = 0.004) or require mechanical
ventilation (16% versus 4.8%, p = 0.03) during
hospitalization when compared to their normal LFT counterparts. (Table
2).
Relation between the pattern of liver injury & patients’ outcomes
– In order to characterize the relation between specific patterns of
liver injury and adverse outcomes, subjects were abnormal LFTs group
were broken down into two subgroups (hepatocellular and cholestatic)
depending on the predominantly elevated hepatic dysfunction marker.
Comparison between these different patterns of liver injury revealed
that patients with predominantly cholestatic pattern of injury were more
likely to meet the primary composite outcome compared to those with
predominant hepatocellular injury (Figure 2).