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Liver Function Tests in COVID-19: Assessment of the Actual Prognostic Value

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Clinical Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
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Statistical Analysis Center, Wroclaw Medical University, Marcinkowski Street 2-6, 50-368 Wroclaw, Poland
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Clinical Department of Urology and Urological Oncology, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
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Department of Basic Science, Faculty of Health Science, Wroclaw Medical University, Bartel Street 5, 51-618 Wroclaw, Poland
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Department of Pharmacology, Wroclaw Medical University, Mikulicz-Radecki Street 2, 50-345 Wroclaw, Poland
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Clinical Department of Internal and Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland
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Clinical Department of Internal Medicine, Pneumology and Allergology, Wroclaw Medical University, M. Skłodowskiej-Curie Street 66, 50-369 Wroclaw, Poland
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Clinical Department of Rheumatology and Internal Medicine, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
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Clinical Department of Gastroenterology and Hepatology, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
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Clinical Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
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Clinical Department of Pediatric Nephrology, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
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Screening Laboratory of Biological Activity Assays and Collection of Biological Material, Faculty of Pharmacy, Wroclaw Medical University, Borowska Street 211A, 50-556 Wroclaw, Poland
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Clinical Department of Gynecology and Obstetrics, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
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Clinical Department and Clinic of Cardiology, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
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Department of Emergency Medicine, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
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Clinical Department of Anaesthesiology and Intensive Therapy, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
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University Hospital in Wroclaw, Institute of Heart Diseases, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
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Authors to whom correspondence should be addressed.
These authors contributed equally to this work.
Academic Editor: Hemant Goyal
J. Clin. Med. 2022, 11(15), 4490; https://doi.org/10.3390/jcm11154490
Received: 4 April 2022 / Revised: 28 July 2022 / Accepted: 29 July 2022 / Published: 1 August 2022
Deviations in laboratory tests assessing liver function in patients with COVID-19 are frequently observed. Their importance and pathogenesis are still debated. In our retrospective study, we analyzed liver-related parameters: aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), gamma-glutamyltransferase (GGT), total bilirubin (TBIL), albumin, comorbidities and other selected potential risk factors in patients admitted with SARS-CoV-2 infection to assess their prognostic value for intensive care unit admission, mechanical ventilation necessity and mortality. We compared the prognostic effectiveness of these parameters separately and in pairs to the neutrophil-to-lymphocyte ratio (NLR) as an independent risk factor of in-hospital mortality, using the Akaike Information Criterion (AIC). Data were collected from 2109 included patients. We created models using a sample with complete laboratory tests n = 401 and then applied them to the whole studied group excluding patients with missing singular variables. We estimated that albumin may be a better predictor of the COVID-19-severity course compared to NLR, irrespective of comorbidities (p < 0.001). Additionally, we determined that hypoalbuminemia in combination with AST (OR 1.003, p = 0.008) or TBIL (OR 1.657, p = 0.001) creates excellent prediction models for in-hospital mortality. In conclusion, the early evaluation of albumin levels and liver-related parameters may be indispensable tools for the early assessment of the clinical course of patients with COVID-19. View Full-Text
Keywords: COVID-19; SARS-CoV-2; severity of COVID-19; hospitalized patients; risk factors; liver COVID-19; SARS-CoV-2; severity of COVID-19; hospitalized patients; risk factors; liver
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MDPI and ACS Style

Tokarczyk, U.; Kaliszewski, K.; Kopszak, A.; Nowak, Ł.; Sutkowska-Stępień, K.; Sroczyński, M.; Sępek, M.; Dudek, A.; Diakowska, D.; Trocha, M.; Gajecki, D.; Gawryś, J.; Matys, T.; Maciejiczek, J.; Kozub, V.; Szalast, R.; Madziarski, M.; Zubkiewicz-Zarębska, A.; Letachowicz, K.; Kiliś-Pstrusińska, K.; Matera-Witkiewicz, A.; Pomorski, M.; Protasiewicz, M.; Sokołowski, J.; Adamik, B.; Kujawa, K.; Doroszko, A.; Madziarska, K.; Jankowska, E.A. Liver Function Tests in COVID-19: Assessment of the Actual Prognostic Value. J. Clin. Med. 2022, 11, 4490. https://doi.org/10.3390/jcm11154490

AMA Style

Tokarczyk U, Kaliszewski K, Kopszak A, Nowak Ł, Sutkowska-Stępień K, Sroczyński M, Sępek M, Dudek A, Diakowska D, Trocha M, Gajecki D, Gawryś J, Matys T, Maciejiczek J, Kozub V, Szalast R, Madziarski M, Zubkiewicz-Zarębska A, Letachowicz K, Kiliś-Pstrusińska K, Matera-Witkiewicz A, Pomorski M, Protasiewicz M, Sokołowski J, Adamik B, Kujawa K, Doroszko A, Madziarska K, Jankowska EA. Liver Function Tests in COVID-19: Assessment of the Actual Prognostic Value. Journal of Clinical Medicine. 2022; 11(15):4490. https://doi.org/10.3390/jcm11154490

Chicago/Turabian Style

Tokarczyk, Urszula, Krzysztof Kaliszewski, Anna Kopszak, Łukasz Nowak, Karolina Sutkowska-Stępień, Maciej Sroczyński, Monika Sępek, Agata Dudek, Dorota Diakowska, Małgorzata Trocha, Damian Gajecki, Jakub Gawryś, Tomasz Matys, Justyna Maciejiczek, Valeriia Kozub, Roman Szalast, Marcin Madziarski, Anna Zubkiewicz-Zarębska, Krzysztof Letachowicz, Katarzyna Kiliś-Pstrusińska, Agnieszka Matera-Witkiewicz, Michał Pomorski, Marcin Protasiewicz, Janusz Sokołowski, Barbara Adamik, Krzysztof Kujawa, Adrian Doroszko, Katarzyna Madziarska, and Ewa Anita Jankowska. 2022. "Liver Function Tests in COVID-19: Assessment of the Actual Prognostic Value" Journal of Clinical Medicine 11, no. 15: 4490. https://doi.org/10.3390/jcm11154490

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