Author/Authors :
Khoonsari, Mahmoodreza Gastrointestinal and Liver Diseases Research Center - Iran University of Medical Sciences, Tehran , Zamani, Farhad Gastrointestinal and Liver Diseases Research Center - Iran University of Medical Sciences, Tehran , Karbalaie Niya, Mohammad Hadi Gastrointestinal and Liver Diseases Research Center - Iran University of Medical Sciences, Tehran , Hemmasi, Gholamreza Gastrointestinal and Liver Diseases Research Center - Iran University of Medical Sciences, Tehran , Ajdarkosh, Hossein Gastrointestinal and Liver Diseases Research Center - Iran University of Medical Sciences, Tehran , Faraji, Amirhossein Gastrointestinal and Liver Diseases Research Center - Iran University of Medical Sciences, Tehran , Nikkhah, Mehdi Gastrointestinal and Liver Diseases Research Center - Iran University of Medical Sciences, Tehran , Pishgar, Elham Gastrointestinal and Liver Diseases Research Center - Iran University of Medical Sciences, Tehran , Jamshidi Makiani, Mahin Antimicrobial Resistant Research Center - Iran University of Medical Sciences, Tehran , Ranjbar, Mitra Department of Infectious Diseases - Iran University of Medical Sciences, Tehran , Safarnezhad Tameshkel, Fahimeh Gastrointestinal and Liver Diseases Research Center - Iran University of Medical Sciences, Tehran , Panahi, Mahshid Gastrointestinal and Liver Diseases Research Center - Iran University of Medical Sciences, Tehran , Ameli, Mitra Gastrointestinal and Liver Diseases Research Center - Iran University of Medical Sciences, Tehran , Yadollahzadeh, Mahdi Department of Internal Medicine - School of Medicine - Iran University of Medical Sciences, Tehran , Farrokhpour, Mohsen Department of Internal Medicine - School of Medicine - Iran University of Medical Sciences, Tehran , Maadi, Mansooreh Gastrointestinal and Liver Diseases Research Center - Iran University of Medical Sciences, Tehran , Ghafari, Abolfazl Department of Internal Medicine - School of Medicine - Iran University of Medical Sciences, Tehran , Valuiyan, Marzieh Department of Cardiology - Iran University of Medical Sciences, Tehran , Pouladi, Masoume Department of Internal Medicine - School of Medicine - Iran University of Medical Sciences, Tehran , Motamed, Nima Department of Social Medicine - Zanjan University of Medical Sciences, Zanjan
Abstract :
Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [COVID-19] quickly turned into a pandemic. Gastrointestinal involvement, especially liver diseases, is one of the main complications of COVID-19 patients.
Objectives: The current study aimed to evaluate the high incidence of liver involvement in COVID-19 hospitalized patients and its association with mortality.
Methods: A total of 560 hospitalized patients with a confirmed diagnosis of COVID-19 were included. Death was considered as the outcome. In addition to liver enzymes, demographic, clinical, and other laboratory data were also collected. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels ≥ 40 were considered as abnormal. To investigate the association between abnormal levels of liver enzymes and death, multiple regression logistic was used.
Results: According to the findings, 29.1% (95% CI = 25.3% - 32.9%) of patients had high levels (≥ 40 IU) of ALT, and 45.1% (95% CI = 40.9% - 49.3%) had high levels of AST (≥ 40 IU). The frequency (based on %) of high levels of AST (≥ 40 U/liter) was significantly higher in patients who died [67.3% (95% CI = 54.5% - 80.1%] of COVID-19 than those who survived [44.9% (95% CI = 39.7% - 50.0%)] (P-value < 0.001). No significant difference was detected in ALT between expired [29.1% (95% CI = 16.7% - 41.5%)] and survived patients [30.7% (95% CI = 25.9% - 35.5%] (P-value = 0.791). AST was found to have an independent association with death in multiple logistic regression (Wald = 4.429, or (95% CI) = 1.014 (1.008 - 1.020), P-value = 0.035).
Conclusions: Liver involvement is a common finding in COVID-19 hospitalized patients. Higher levels of AST were significantly associated with an increased mortality rate in COVID-19 patients.
