scholarly journals Characteristics and outcomes of patients with COVID-19 and liver injury: a retrospective analysis and a multicenter experience

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Andrei Voiosu ◽  
Adina Roman ◽  
Ruxandra Pop ◽  
Alina Boeriu ◽  
Cristiana Popp ◽  
...  
Keyword(s):  
Liver Disease ◽  
Liver Injury ◽  
Liver Function ◽  
Chronic Liver Disease ◽  
Liver Function Tests ◽  
Chronic Liver ◽  
Upper Limit ◽  
Function Tests ◽  
Elevated Liver Function Tests ◽  
Negative Outcome

Abstract Background and aims: Patients with COVID-19 frequently present abnormal elevated liver function tests of unknown clinical significance. We aimed to investigate the characteristics and factors influencing outcome in patients with confirmed SARS-CoV-2 infection and liver injury on admission. Methods: This is a retrospective observational study of patients hospitalized in two COVID units in Romania. Relevant data on clinical and laboratory parameters and medication administered during the admission were analyzed to identify predictors of a negative outcome. Patients with confirmed COVID-19 and liver function tests (LFTs) above the upper limit of normal were included in the analysis. Results: From 1,207 patients, we identified 134 patients (11%) with abnormal LFTs during hospitalization. The majority of patients had mildly elevated levels and a predominantly cholestatic pattern of liver injury. Patients who received lopinavir/ritonavir were more likely to have increased ALAT levels (p<0.0001). Sixteen patients had pre-existing chronic liver disease, and they were more likely to suffer from severe COVID-19 (p=0.009) and have a negative outcome (p<0.001), but on multivariate analysis, only the severity of COVID-19 was predictive of death (OR 69.9; 95% CI 6.4-761.4). Conclusions: Mild liver injury is relatively common in COVID-19 and possibly influenced by medication. Patients with chronic liver disease are at high risk for negative outcome, but the severity of the infection is the only predictor of death.

Echo-doppler hepatic measurements combined with quantitative liver function tests in chronic liver disease

2000 ◽  
Vol 32 ◽  
pp. 223
Author(s):  
A. Fasoli ◽  
P. Borro ◽  
F. Botta ◽  
B. Chiarbonello ◽  
P. Durando ◽  
...  
Keyword(s):  
Liver Disease ◽  
Liver Function ◽  
Chronic Liver Disease ◽  
Liver Function Tests ◽  
Chronic Liver ◽  
Function Tests

Detecting chronic liver disease: are liver function tests the solution?

2020 ◽  
Vol 81 (2) ◽  
pp. 1-8
Author(s):  
Prarthana Thiagarajan ◽  
Jane Chalmers ◽  
Indra N Guha ◽  
Martin W James
Keyword(s):  
Liver Disease ◽  
Liver Function ◽  
Chronic Liver Disease ◽  
Liver Function Tests ◽  
Chronic Liver ◽  
Alcoholic Fatty Liver ◽  
Non Invasive ◽  
Function Tests ◽  
Life Years ◽  
The Uk

By 2020, chronic liver disease will have eclipsed ischaemic heart disease as the leading cause of working life years lost in the UK. As mortality from chronic liver disease continues to rise, the landscape of aetiology has shifted from infectious to non-communicable causes. In parallel with the growing prevalence of obesity and type 2 diabetes, non-alcoholic fatty liver disease is estimated to affect 25% of the UK adult population. Simultaneously, escalating alcohol consumption has fuelled public health and economic concerns regarding its widespread impact on working-age adults. Given that chronic liver disease remains clinically silent until its advanced stages, there is an urgent unmet need to identify affected individuals earlier in the disease process, enabling targeted intervention strategies which may improve prognosis. Robust epidemiological data have shown that liver fibrosis is the strongest predictor of clinically meaningful outcomes, including decompensation, liver cancer and overall mortality. Detecting fibrosis among at-risk individuals, in a manner that is reproducible, non-invasive, safe and cost effective, has become a major challenge of our time. This article addresses the pitfalls of the standard panel of liver function tests, discusses other non-invasive biomarkers and reviews imaging technologies which may revolutionise community-based diagnosis and stratification of chronic liver disease.

Quantitative liver function tests in chronic liver disease

2000 ◽  
Vol 32 ◽  
pp. A125
Author(s):  
Alberto Fasoli ◽  
Edoardo Giannini ◽  
Bruno Chiarbonello ◽  
Emanuela Testa ◽  
Paola Romagnoli ◽  
...  
Keyword(s):  
Liver Disease ◽  
Liver Function ◽  
Chronic Liver Disease ◽  
Liver Function Tests ◽  
Chronic Liver ◽  
Function Tests

Propafenone-Induced Liver Injury

1992 ◽  
Vol 26 (7-8) ◽  
pp. 926-928 ◽  
Author(s):  
Sarah A. Spinier ◽  
Cheryl A. Elder ◽  
K. Elizabeth Kindwall
Keyword(s):  
Atrial Fibrillation ◽  
Liver Injury ◽  
Liver Function ◽  
Care Center ◽  
Tertiary Care ◽  
Liver Function Tests ◽  
Tertiary Care Center ◽  
Upper Limit ◽  
Function Tests ◽  
Recurrent Atrial Fibrillation

OBJECTIVE: To describe propafenone-induced liver injury. DESIGN: Retrospective case report. SETTING: Referred care in a large tertiary care center. Laboratory tests were performed at the auxiliary site and the tertiary care center. PATIENT: A 71-year-old woman with atrial fibrillation developed elevations of greater than two times the upper limit of normal in alkaline phosphatase (ALK), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma glutamyltransferase (GGT) after initiation of propafenone therapy. INTERVENTIONS: Studies included serial measurements of ALK, ALT, AST, and GGT. RESULTS: The patient developed elevations of greater than two times the upper limit of normal in ALK, ALT, and AST, one month after initiating propafenone therapy. The propafenone dose was decreased from 900 to 675 mg/d and, ten days later, the ALK, ALT, and AST were decreased slightly, but still above the upper limit of normal. One month later, serum transaminases had returned to baseline, but propafenone therapy was discontinued because of recurrent atrial fibrillation, persistent elevation in ALK, and elevation in GGT. Two months after discontinuing propafenone, serum aminotransaminase and ALK concentrations had normalized and GGT had decreased and remained only slightly elevated. CONCLUSIONS: The occurrence of liver injury secondary to propafenone therapy is rare. Reported cases appear to be secondary to hepatocellular injury, cholestasis, or a combination of the two. In this case, the pattern demonstrated by elevations in liver enzymes may be classified as acute cholestatic liver injury. Because the reported incidence is 0.1–0.2 percent and there are no known fatalities secondary to propafenone liver injury, routine monitoring of liver function tests in all patients receiving propafenone cannot be recommended at this time. Baseline liver function tests prior to initiating propafenone therapy with follow-up laboratory studies one month later are recommended in patients with known liver dysfunction. If elevations are noted, a reduction in dose may result in lower liver enzyme concentrations, although discontinuation of therapy may be required in some cases.

scholarly journals Possible unrecognised liver injury is associated with mortality in critically ill COVID-19 patients

2021 ◽  
Vol 14 ◽  
pp. 175628482110234
Author(s):  
Mario Romero-Cristóbal ◽  
Ana Clemente-Sánchez ◽  
Patricia Piñeiro ◽  
Jamil Cedeño ◽  
Laura Rayón ◽  
...  
Keyword(s):  
Liver Disease ◽  
Liver Fibrosis ◽  
Liver Injury ◽  
Chronic Liver Disease ◽  
Critically Ill ◽  
Cox Regression ◽  
Chronic Liver ◽  
Cox Regression Analysis ◽  
Risk Of Death ◽  
The Impact

Background: Coronavirus disease (COVID-19) with acute respiratory distress syndrome is a life-threatening condition. A previous diagnosis of chronic liver disease is associated with poorer outcomes. Nevertheless, the impact of silent liver injury has not been investigated. We aimed to explore the association of pre-admission liver fibrosis indices with the prognosis of critically ill COVID-19 patients. Methods: The work presented was an observational study in 214 patients with COVID-19 consecutively admitted to the intensive care unit (ICU). Pre-admission liver fibrosis indices were calculated. In-hospital mortality and predictive factors were explored with Kaplan–Meier and Cox regression analysis. Results: The mean age was 59.58 (13.79) years; 16 patients (7.48%) had previously recognised chronic liver disease. Up to 78.84% of patients according to Forns, and 45.76% according to FIB-4, had more than minimal fibrosis. Fibrosis indices were higher in non-survivors [Forns: 6.04 (1.42) versus 4.99 (1.58), p < 0.001; FIB-4: 1.77 (1.17) versus 1.41 (0.91), p = 0.020)], but no differences were found in liver biochemistry parameters. Patients with any degree of fibrosis either by Forns or FIB-4 had a higher mortality, which increased according to the severity of fibrosis ( p < 0.05 for both indexes). Both Forns [HR 1.41 (1.11–1.81); p = 0.006] and FIB-4 [HR 1.31 (0.99–1.72); p = 0.051] were independently related to survival after adjusting for the Charlson comorbidity index, APACHE II, and ferritin. Conclusion: Unrecognised liver fibrosis, assessed by serological tests prior to admission, is independently associated with a higher risk of death in patients with severe COVID-19 admitted to the ICU.

scholarly journals Chronic liver disease not a significant comorbid condition for COVID-19

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jiahao Lin ◽  
Bingting Bao ◽  
Nigar Anjuman Khurram ◽  
Kasey Halsey ◽  
Ji Whae Choi ◽  
...  
Keyword(s):  
Liver Disease ◽  
Liver Injury ◽  
Chronic Liver Disease ◽  
The United States ◽  
Postmortem Examination ◽  
Chronic Liver ◽  
Critical Groups ◽  
Comorbid Condition ◽  
Central Vein ◽  
Significant Difference

AbstractTo explore the role of chronic liver disease (CLD) in COVID-19. A total of 1439 consecutively hospitalized patients with COVID-19 from one large medical center in the United States from March 16, 2020 to April 23, 2020 were retrospectively identified. Clinical characteristics and outcomes were compared between patients with and without CLD. Postmortem examination of liver in 8 critically ill COVID-19 patients was performed. There was no significant difference in the incidence of CLD between critical and non-critical groups (4.1% vs 2.9%, p = 0.259), or COVID-19 related liver injury between patients with and without CLD (65.7% vs 49.7%, p = 0.065). Postmortem examination of liver demonstrated mild liver injury associated central vein outflow obstruction and minimal to moderate portal lymphocytic infiltrate without evidence of CLD. Patients with CLD were not associated with a higher risk of liver injury or critical/fatal outcomes. CLD was not a significant comorbid condition for COVID-19.

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