Liver dysfunction in COVID-19: a useful prognostic marker of severe disease?

BackgroundCOVID-19 is a global pandemic caused by the novel coronavirus SARS-CoV-2. Risk factors and prognostic markers of severe disease remain to be fully determined, although some studies have suggested a correlation between abnormal liver function and adverse outcomes. Further studies are needed to investigate this further.MethodsThis retrospective study enrolled patients with a confirmed diagnosis of COVID-19 who were admitted to Kingston Hospital in the UK. Data collected included age, sex, ethnicity, comorbidity profile, biochemical markers of liver function and the acute phase response, and overall outcome.ResultsBetween 16 March 2020 and 30 April 2020, a total of 343 patients were admitted to the acute medical team at Kingston Hospital. Excluding those with a history of liver disease, 299 patients had liver function tests performed with abnormalities demonstrated in 44.8% of individuals. Derangement of liver function was associated with greater need for ventilatory support (p<0.001), admission to high dependency unit or intensive care (p<0.001) and increased length of hospital stay (p<0.001). Of note, liver dysfunction was more common in those of non-white ethnicity (p=0.007) and correlated with higher levels of C reactive protein (p=0.01) and ferritin (p<0.001).ConclusionAbnormal liver function is associated with a negative outcome among those hospitalised with COVID-19. The cause for this association is unclear, but correlation between abnormal liver function and higher serum levels of acute phase proteins suggest that dysregulation of the immune system in response to SARS-CoV-2 may be contributory.

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Abnormal Liver Function Tests and Long-Term Outcomes in Patients Discharged after Acute Heart Failure

Journal of Clinical Medicine ◽

10.3390/jcm10081730 ◽

2021 ◽

Vol 10 (8) ◽

pp. 1730

Author(s):

Hiroshi Miyama ◽

Yasuyuki Shiraishi ◽

Shun Kohsaka ◽

Ayumi Goda ◽

Yosuke Nishihata ◽

...

Keyword(s):

Heart Failure ◽

Liver Function ◽

Liver Function Tests ◽

Abnormal Liver Function ◽

Adverse Outcomes ◽

Long Term Outcomes ◽

Function Tests ◽

Parameter Values

Abnormal liver function tests (LFTs) are known to be associated with impaired clinical outcomes in heart failure (HF) patients. However, this implication varies with each single LFT panel. We aim to evaluate the long-term outcomes of acute HF (AHF) patients by assessing multiple LFT panels in combination. From a prospective multicenter registry in Japan, 1158 AHF patients who were successfully discharged were analyzed (mean age, 73.9 ± 13.5 years; men, 58%). LFTs (i.e., total bilirubin, aspartate aminotransferase or alanine aminotransferase, and alkaline phosphatase) at discharge were assessed; borderline and abnormal LFTs were defined as 1 and ≥2 parameter values above the normal range, respectively. The primary endpoint was composite of all-cause death or HF readmission. At the time of discharge, 28.7% and 8.6% of patients showed borderline and abnormal LFTs, respectively. There were 196 (16.9%) deaths and 298 (25.7%) HF readmissions during a median 12.4-month follow-up period. The abnormal LFTs group had a significantly higher risk of experiencing the composite outcome (adjusted hazard ratio: 1.51, 95% confidence interval: 1.08–2.12, p = 0.017), whereas the borderline LFTs group was not associated with higher risk of adverse events when referenced to the normal LFTs group. Among AHF patients, the combined elevation of ≥2 LFT panels at discharge was associated with long-term adverse outcomes.

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Reduction of liver function delays resumption of postpartum ovarian activity and alters the synthesis of acute phase proteins in dairy cows

Research in Veterinary Science ◽

10.1016/j.rvsc.2016.02.015 ◽

2016 ◽

Vol 106 ◽

pp. 84-88 ◽

Cited By ~ 3

Author(s):

Paula Montagner ◽

Ana Rita Tavares Krause ◽

Elizabeth Schwegler ◽

Marina Menoncin Weschenfelder ◽

Viviane Rohrig Rabassa ◽

...

Keyword(s):

Liver Function ◽

Dairy Cows ◽

Acute Phase ◽

Acute Phase Proteins ◽

Ovarian Activity

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Convalescent Plasma for COVID-19- is it Time to Say Goodbye? A Single-Center, Retrospective, Observational Study from Northern India

International Blood Research & Reviews ◽

10.9734/ibrr/2021/v12i430158 ◽

2021 ◽

pp. 32-43

Author(s):

Rasika Setia ◽

Mitu Dogra ◽

Gokhula Prasath Thangavel ◽

Ramesh Yadav ◽

Amena Ebadur Rahman ◽

...

Keyword(s):

Observational Study ◽

Hospital Stay ◽

Disease Progression ◽

Severe Disease ◽

Ventilatory Support ◽

Length Of Hospital Stay ◽

Severe Infection ◽

Northern India ◽

Conflicting Evidence ◽

Group 2

Background: COVID-19 pandemic continues threatening the world with no effective treatment to tackle the menace. Till date, there is conflicting evidence on efficacy of CP in reducing COVID-19 related mortality. The objective of this study was to see disease progression and 7, 14 and 28-day mortality after CP therapy and analyze CP efficacy with/without Remdesivir. Materials and Methods: A retrospective single-centre observational study done from August 20, 2020, to 20 November 2020. Records of 294 COVID-19 patients with moderate to severe disease given CP therapy were analysed based on disease progression and length of hospital stay, further subcategorized on age, clinical profile, risk factors, ward/ICU, ventilatory support and co-administration of Remdesivir. Results: Lowest 7-day mortality rate was seen within age group 20-40 years (0%) and was highest in ≥61 years (24.3%). 87 patients on ventilatory support showed higher 28day mortality (48.28%) compared to non-ventilated (10.14%), (P<0.00001). Lesser 7-day mortality was seen in early CP therapy ≤3 days of admission (P=0.01). Patients requiring ICU admission showed higher 14 and 28-day mortality compared to ward P=0.001%). Median (IQR) length of hospital stay from CP transfusion was shorter, 4 (3 to 9) days in group 2 (CP only) compared to 7 (4 to 12) days in group1 (CP+Remdesivir ). Conclusion: CP therapy in ≤3 days of hospital admission in COVID-19 patients with moderate to severe infection not on ventilatory support showed reduction in mortality and length of hospital stay. Length of hospital stay was shorter in the CP-only group as compared to the CP+ Remdesivir group.

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Night shift work and abnormal liver function: is non-alcohol fatty liver a necessary mediator?

Occupational and Environmental Medicine ◽

10.1136/oemed-2018-105273 ◽

2018 ◽

Vol 76 (2) ◽

pp. 83-89 ◽

Cited By ~ 6

Author(s):

Feng Wang ◽

Liuzhuo Zhang ◽

Suyang Wu ◽

Wentao Li ◽

Miaomiao Sun ◽

...

Keyword(s):

Liver Function ◽

Fatty Liver ◽

Shift Work ◽

Liver Dysfunction ◽

Night Shift ◽

Abnormal Liver Function ◽

Mediation Effect ◽

Shift Workers ◽

Night Shift Work ◽

Male Workers

ObjectivesAccumulated evidence implies that night shift work may trigger liver dysfunction. Non-alcoholic fatty liver (NAFL) is suggested to be a necessary mediator in this process. This study aimed to examine the relationship between night shift work and elevated level of alanine transaminase (e-ALT) of workers and investigate the potential mediation effect of NAFL.MethodsThis study included all male workers from the baseline survey of a cohort of night shift workers. Information on demographics, lifestyle and lifetime working schedule was collected by face-to-face interview. Liver sonography was used to identify NAFL cases. Serum ALT level was detected by an automatic biochemical analyser. e-ALT was defined as ALT >40 U/L. Logistic regression models were used to evaluate ORs, and mediation analysis was employed to examine the mediation effect.ResultsAmong 4740 male workers, 39.5% were night shift workers. Night shift workers had an increased risk of e-ALT (OR, 1.19, 95% CI 1.00 to 1.42). With the increase in night shift years, the OR of e-ALT increased from 1.03 (95% CI 0.77 to 1.36) to 1.60 (95% CI 1.08 to 2.39) among workers without NAFL. A similar trend was not found among workers with NAFL. In addition, no significant mediation effect of NAFL in the association between night shift work and e-ALT was found.ConclusionsNight shift work is positively associated with abnormal liver function, in particular among workers without NAFL. Shift work involving circadian disruption is likely to exert a direct effect on liver dysfunction rather than rely on the mediation effect of NAFL.

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