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Prevalence and Prognostic Impact of Deranged Liver Blood Tests in COVID-19: Experience from the Regional COVID-19 Center over the Cohort of 3812 Hospitalized Patients

1
Department of Gastroenterology, Hepatology and Clinical Nutrition, University Hospital Dubrava, 10000 Zagreb, Croatia
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Department of Hematology, University Hospital Dubrava, 10000 Zagreb, Croatia
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Department of Gastroenterology, Hepatology and Clinical Nutrition, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
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Department of Emergency Medicine, University Hospital Dubrava, 10000 Zagreb, Croatia
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Department of Gastroenterology and Hepatology, University Hospital Merkur, 10000 Zagreb, Croatia
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Department of Gastroenterology and Hepatology, University Hospital Sestre Milosrdnice, 10000 Zagreb, Croatia
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Department of Gastroenterology and Hepatology, University Hospital Sveti Duh, 10000 Zagreb, Croatia
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Department of Gastroenterology and Hepatology, University Hospital Center Zagreb, 10000 Zagreb, Croatia
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Department of Maxillofacial Surgery, University Hospital Dubrava, 10000 Zagreb, Croatia
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Department of Pulmology, University Hospital Dubrava, 10000 Zagreb, Croatia
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Intensive Care Unit, Department of Internal Medicine, University Hospital Dubrava, 10000 Zagreb, Croatia
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Intensive Care Unit, Department of Anestesiology, Renimatology and Intensive Care, University Hospital Dubrava, 10000 Zagreb, Croatia
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Department of Anestesiology, Renimatology and Intensive Care, School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia
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Faculty of Pharmacy and Biochemistry, University of Zagreb, 10000 Zagreb, Croatia
*
Author to whom correspondence should be addressed.
Academic Editor: Robert Flisiak
J. Clin. Med. 2021, 10(18), 4222; https://doi.org/10.3390/jcm10184222
Received: 4 August 2021 / Revised: 10 September 2021 / Accepted: 14 September 2021 / Published: 17 September 2021
(This article belongs to the Special Issue Updates in Management of SARS-CoV-2 Infection)
Background: Derangement of liver blood tests (LBT) is frequent in patients with Coronavirus disease 2019 (COVID-19). We aimed to evaluate (a) the prevalence of deranged LBT as well as their association with (b) clinical severity at admission and (c) 30-day outcomes among the hospitalized patients with COVID-19. Methods: Consecutive patients with COVID-19 hospitalized in the regional referral center over the 12-month period were included. Clinical severity of COVID-19 at hospital admission and 30-day outcomes (need for intensive care, mechanical ventilation, or death) were analyzed. Results: Derangement of LBT occurred in 2854/3812 (74.9%) of patients, most frequently due to elevation of AST (61.6%), GGT (46.1%) and ALT (33.4%). Elevated AST, ALT, GGT and low albumin were associated with more severe disease at admission. However, in multivariate Cox regression analysis, when adjusted for age, sex, obesity and presence of chronic liver disease, only AST remained associated with the risk of dying (HR 1.5081 and 2.1315, for elevations 1–3 × ULN and >3 × ULN, respectively) independently of comorbidity burden and COVID-19 severity at admission. Patients with more severe liver injury more frequently experienced defined adverse outcomes. Conclusions: Deranged LBTs are common among patients hospitalized with COVID-19 and might be used as predictors of adverse clinical outcomes. View Full-Text
Keywords: COVID-19; liver functional tests; mortality COVID-19; liver functional tests; mortality
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MDPI and ACS Style

Paštrovic, F.; Lucijanic, M.; Atic, A.; Stojic, J.; Barisic Jaman, M.; Tjesic Drinkovic, I.; Zelenika, M.; Milosevic, M.; Medic, B.; Loncar, J.; Mijic, M.; Filipec Kanizaj, T.; Kralj, D.; Lerotic, I.; Virovic Jukic, L.; Ljubicic, N.; Luetic, K.; Grgic, D.; Majerovic, M.; Ostojic, R.; Krznaric, Z.; Luksic, I.; Piskac Zivkovic, N.; Keres, T.; Grabovac, V.; Persec, J.; Barsic, B.; Grgurevic, I. Prevalence and Prognostic Impact of Deranged Liver Blood Tests in COVID-19: Experience from the Regional COVID-19 Center over the Cohort of 3812 Hospitalized Patients. J. Clin. Med. 2021, 10, 4222. https://doi.org/10.3390/jcm10184222

AMA Style

Paštrovic F, Lucijanic M, Atic A, Stojic J, Barisic Jaman M, Tjesic Drinkovic I, Zelenika M, Milosevic M, Medic B, Loncar J, Mijic M, Filipec Kanizaj T, Kralj D, Lerotic I, Virovic Jukic L, Ljubicic N, Luetic K, Grgic D, Majerovic M, Ostojic R, Krznaric Z, Luksic I, Piskac Zivkovic N, Keres T, Grabovac V, Persec J, Barsic B, Grgurevic I. Prevalence and Prognostic Impact of Deranged Liver Blood Tests in COVID-19: Experience from the Regional COVID-19 Center over the Cohort of 3812 Hospitalized Patients. Journal of Clinical Medicine. 2021; 10(18):4222. https://doi.org/10.3390/jcm10184222

Chicago/Turabian Style

Paštrovic, Frane, Marko Lucijanic, Armin Atic, Josip Stojic, Mislav Barisic Jaman, Ida Tjesic Drinkovic, Marko Zelenika, Marko Milosevic, Barbara Medic, Jelena Loncar, Maja Mijic, Tajana Filipec Kanizaj, Dominik Kralj, Ivan Lerotic, Lucija Virovic Jukic, Neven Ljubicic, Kresimir Luetic, Dora Grgic, Matea Majerovic, Rajko Ostojic, Zeljko Krznaric, Ivica Luksic, Nevenka Piskac Zivkovic, Tatjana Keres, Vlatko Grabovac, Jasminka Persec, Bruno Barsic, and Ivica Grgurevic. 2021. "Prevalence and Prognostic Impact of Deranged Liver Blood Tests in COVID-19: Experience from the Regional COVID-19 Center over the Cohort of 3812 Hospitalized Patients" Journal of Clinical Medicine 10, no. 18: 4222. https://doi.org/10.3390/jcm10184222

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