Portal de Periódicos da CAPES

The role of liver steatosis as measured with transient elastography and transaminases on hard clinical outcomes in patients with COVID-19

2021; SAGE Publishing; Volume: 14; Linguagem: Inglês

10.1177/17562848211016567

1756-2848

Isabel Campos‐Varela, Ares Villagrasa, Macarena Simón‐Talero, Mar Riveiro‐Barciela, Meritxell Ventura‐Cots, Lara Aguilera, Patricia Alvarez-Lopez, Emilie Anderssen-Nordahl, Adrian Anton, Juan Bañares, Claudia Barber, Ana Barreira‐Díaz, Betina Biagetti, Laura Camps-Relats, Andreea Ciudin, R. Cocera, Cristina Dopazo, A. Sellas Fernandez, César Jimenez, Moraima Jiménez, Mariona Jofra, Clara Gil, Concepción Gómez‐Gavara, Danila Guanozzi, Jorge Guevara, Beatriz Lobo, Carolina Malagelada, Joan Martínez‐Campreciós, L Mayorga, Enric Gallén Miret, Elizabeth Pando, Ana Pérez-Lopez, Marc Pigrau, Alba Prio, Jesús Rivera‐Esteban, Alba Romero, Stephanie Tasayco, Judit Vidal‐González, Laura Vidal, Beatriz Mínguez, Salvador Augustín, Joan Genescà,

Pancreatitis Pathology and Treatment

Liver injury has been widely described in patients with Coronavirus disease 2019 (COVID-19). We aimed to study the effect of liver biochemistry alterations, previous liver disease, and the value of liver elastography on hard clinical outcomes in COVID-19 patients. We conducted a single-center prospective observational study in 370 consecutive patients admitted for polymerase chain reaction (PCR)-confirmed COVID-19 pneumonia. Clinical and laboratory data were collected at baseline and liver parameters and clinical events recorded during follow-up. Transient elastography [with Controlled Attenuation Parameter (CAP) measurements] was performed at admission in 98 patients. All patients were followed up until day 28 or death. The two main outcomes of the study were 28-day mortality and the occurrence of the composite endpoint intensive care unit (ICU) admission and/or death. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels were elevated at admission in 130 patients (35%) and 167 (45%) patients, respectively. Overall, 14.6% of patients presented the composite endpoint ICU and/or death. Neither ALT elevations, prior liver disease, liver stiffness nor liver steatosis (assessed with CAP) had any effect on outcomes. However, patients with abnormal baseline AST had a higher occurrence of the composite ICU/death (21% versus 9.5%, p = 0.002). Patients ⩾65 years and with an AST level > 50 U/ml at admission had a significantly higher risk of ICU and/or death than those with AST ⩽ 50 U/ml (50% versus 13.3%, p < 0.001). In conclusion, mild liver damage is prevalent in COVID-19 patients, but neither ALT elevation nor liver steatosis influenced hard clinical outcomes. Elevated baseline AST is a strong predictor of hard outcomes, especially in patients ⩾65 years.