scholarly journals Association of COVID-19 with Hepatic Injury Prevalence and Associated Factors

2021 ◽  
Vol 21 (9) ◽  
Author(s):  
Hind Ibrahim Fallatah ◽  
Waleed S Al Ghamdi ◽  
Saad M Al Dosari ◽  
Abdullah H Jabbad ◽  
Majed Fagih ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Liver Injury ◽  
Retrospective Cohort ◽  
Associated Factors ◽  
Hepatic Injury ◽  
Admission Rate ◽  
Liver Function Tests ◽  
The Mean ◽  
Icu Transfer ◽  
Novel Coronavirus

Background: Novel Coronavirus Disease 19 (COVID-19) was reported by the WHO as a pandemic in March 2020. It was associated with liver injury in up to 50% of patients. This retrospective cohort study investigated the prevalence and associated factors of liver injury among COVID-19 patients. Methods: We include 2319 consecutive COVID-19 patients from April 2020 to November 2020. Liver function tests were performed at baseline, 24–48 h after admission, and before mortality/discharge. We compared Saudis and non-Saudis, in admission rate, serum ALT level, morbidity, and mortality. Serum ALT was compared between sexes, admitted and non-admitted patients, and the deceased and survivors. Results: Men (1356; 58.5%) and non-Saudis (1328; 57.3%) were predominant. The mean (SD) age was 41.67 ± 18.3 years (18 - 100). One-third of the patients had comorbidities, and 1022 (44.1%) required hospital admission. Intensive Care Unit (ICU) transfer was required in 185/1022 (18%). Male and non-Saudis were most likely to be transferred to the ICU (P < 0.001). Hepatocellular liver injury was found in 797 (34.4%) patients. Male and admitted patients were more likely to have a hepatic injury (P = 0.001). Conclusions: The mortality rate among admitted patients was 17.8% (182/1022). Mortality was associated with older age and hepatic injury (P < 0.001 and P = 0.004, respectively).

scholarly journals Methimazole induced hepatotoxicity: A rare adverse reaction

2019 ◽  
Vol 6 (3) ◽  
pp. 1
Author(s):  
Kevin C. Kohm ◽  
Lauren Pioppo ◽  
Jack Xu ◽  
Preston Keiffer ◽  
Eric Pagan ◽  
...  
Keyword(s):  
Liver Injury ◽  
Liver Function ◽  
Side Effect ◽  
Hepatic Injury ◽  
Total Bilirubin ◽  
Liver Function Tests ◽  
Side Effect Profile ◽  
Function Tests ◽  
Painless Jaundice ◽  
Graves Orbitopathy

Methimazole (MMI) is a commonly used medication in the treatment of hyperthyroidism. The side effect profile is extensive and includes the rare but serious side effect of drug associated liver injury. We report the case of a 51-year-old female who presented with painless jaundice several weeks after initiating MMI therapy for treatment of hyperthyroidism complicated by Graves’ orbitopathy. Liver function tests on presentation showed alanine aminotransferase (ALT) 1366 IU/L, aspartate aminotransferase (AST) 853 IU/L, total bilirubin 26.2 mg/dl, alkaline phosphatase 954 IU/L. Workup of structural, infectious, and autoimmune causes of hepatic injury was negative. The patient was therefore found to have MMI associated liver injury. MMI was discontinued and the patient was started on ursodiol, resulting in resolution of her jaundice and improvement of her liver function tests.

scholarly journals Acute kidney and liver injury could be the cause of death in patients with COVID-19

2021 ◽  
Author(s):  
Qutaiba Al Khames Aga ◽  
Kawthar Nassir ◽  
Hesham Al Mawla ◽  
Hassan Abbas ◽  
Jawad Rasheed ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Liver Injury ◽  
Poor Prognosis ◽  
Hepatic Injury ◽  
Total Bilirubin ◽  
Serum Bilirubin ◽  
Stage Iv ◽  
Liver Function Tests ◽  
Total Serum ◽  
Baseline Values

We evaluated the increase in the risk of developing acute kidney and hepatic injury. Moreover, we investigate the association between kidney and liver biomarkers with poor prognosis and mortality rate. Methods: This was a prospective cohort study of 397 adult patients with an average age of 48.03 ± 14.09 were diagnosed with COVID-19 of whom, 46 (11.59%) died in hospital. The upper values of the kidney and liver biomarkers were obtained from the recovered patients during the disease period and are compared to the data for dead patients at admission (Baseline) and one day before death. Results: At admission to the hospital, the baseline S.Cr, BUN, and eGFR were not significantly varied between recovered and dead patients. Furthermore, the baseline values for AST, ALT, and ALP were not significantly differed between both groups. Whereas, baseline value of total serum bilirubin was higher in died compared to the recovered patients. For dead patients, the day before death, 52.17% of the patients had progressed to stage III and stage IV AKI. S.Cr and BUN were significantly higher, and eGFR was lower compared to the recovered patients. All of the kidney and liver function tests were abnormally increased from baseline to the day before death. The AST, ALT, and total bilirubin one day before death were significantly higher compared to their baseline value. Conclusions: COVID-19 patients have a high risk for the development of AKI and liver injury that can be progressed to a chronic stage and increase the mortality rate.

scholarly journals The Effects of Early Rehabilitation in the Intensive Care Unit for Patients with Severe COVID-19 Pneumonia: A Retrospective Cohort Study

2022 ◽  
Vol 11 (2) ◽  
pp. 357
Author(s):  
Tokio Kinoshita ◽  
Yukihide Nishimura ◽  
Yasunori Umemoto ◽  
Yasuhisa Fujita ◽  
Ken Kouda ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cohort Study ◽  
Intensive Care ◽  
Length Of Stay ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Small Sample ◽  
Icu Length Of Stay ◽  
The Mean ◽  
Mean Time

This retrospective cohort study aimed to examine the rehabilitation effect of patients with coronavirus disease 2019 (COVID-19) in the intensive care unit (ICU) under mechanical ventilation and included ICU patients from a university hospital who received rehabilitation under ventilator control until 31 May 2021. Seven patients were included, and three of them died; thus, the results of the four survivors were examined. The rehabilitation program comprised the extremity range-of-motion training and sitting on the bed’s edge. The Sequential Organ Failure Assessment score (median (25–75th percentiles)) at admission was 7.5 (5.75–8.5), and the activities of daily living (ADLs) were bedridden, the lowest in the Functional Independence Measure (FIM) and Barthel Index (BI) surveys. Data on the mean time to extubation, ICU length of stay, and ADLs improvement (FIM and BI) during ICU admission were obtained. Inferential analyses were not performed considering the small sample size. The mean time to extubation was 4.9 ± 1.1 days, and the ICU length of stay was 11.8 ± 5.0 days. ΔFIM was 36.5 (28.0–40.5), and the ΔBI was 22.5 (3.75–40.0). Moreover, no serious adverse events occurred in the patients during rehabilitation. Early mobilization of patients with COVID-19 may be useful in ADLs improvement during ICU stay.

scholarly journals Cardiovascular Risk Factors and Evolution of Patients Attended with COVID-19 in a National Reference Hospital from Lima, Peru

2020 ◽  
Author(s):  
Germán V. Valenzuela ◽  
Alfonso J. Rodriguez-Morales ◽  
Roxana Mamani ◽  
Ricardo Ayala ◽  
Katherine Pérez ◽  
...  
Keyword(s):  
Risk Factors ◽  
Latin America ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Retrospective Cohort ◽  
Associated Factors ◽  
National Reference ◽  
Reference Hospital ◽  
The Mean ◽  
Clinical Records

Coronavirus disease 2019 (COVID-19) fatal outcomes have been associated with multiple cardiovascular risk factors. In new epidemic areas, such as Latin America, there is a lack of studies about this. Here, we evaluated those factors in a retrospective cohort of patients in a national reference hospital of Lima, Peru. Design. A retrospective cohort observational study was done. For this study, information was obtained from clinical records of the hospital for the cases that were laboratory-diagnosed and related, during March 6th and April 30th, 2020. rRT-PCR was used for the detection of the RNA of SARS-CoV-2 following the protocol Charit&eacute;, Berlin, Germany, from nasopharyngeal swabs at the National Institute of Health. Calculation of the odds ratio (OR) with the respective 95% confidence interval (95% CI) was done, also logistic regression for adjusted OR (multivariate) was done. Values of p &lt; 0.05 were considered significant for all analyses. Results. One hundred six hospitalized patients were evaluated. The mean age of patients was 61.58 years (SD 16.81). Cardiovascular risk factors among them were hypertension (46.2%), diabetes (28.3%), and obesity (28.3%), among others. Fifty-six patients died (52.8%). Mortality associated factors at the multivariate analysis were arterial hypertension (OR=1.343, 95% 1.089-1.667), myocardial injury (OR=1.303, 95% 1.031-1.642), and mechanical ventilation (OR 1.262, 95% 1.034-1.665), as associated factors. Conclusion. As observed in other regions of the world, cardiovascular risk factors represent a significant and independent threat to be considered in patients with COVID-19. Further studies and interventions in Peru and Latin America are expected.

scholarly journals Impact of the Severity of Liver Injury in COVID-19 Patients Admitted to an Intensive Care Unit During the SARS-CoV2 Pandemic Outbreak

2021 ◽  
Vol 7 (3) ◽  
pp. 211-216
Author(s):  
Adina Roman ◽  
Septimiu Moldovan ◽  
Ario Santini ◽  
Mircea Stoian ◽  
Daniela Dobru
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Liver Injury ◽  
Liver Function ◽  
Epidemiological Data ◽  
Liver Function Tests ◽  
Albumin Level ◽  
World Health ◽  
Female Ratio ◽  
Function Tests

Abstract Introduction: The World Health Organization (WHO) identified a novel coronavirus, originating in Wuhan, China, in December 2019, as a pneumonia causing pathogen. Epidemiological data in Romania show more than 450.000 confirmed patients, with a constant number of approximately 10% admission in intensive care unit. Method: A retrospective, observational study was conducted from 1st March to 30th October 2020, comprising 657 patients, confirmed as having COVID-19, and who had been admitted to the intensive care unit of the Mures County Clinical Hospital, Tîrgu Mures, Romania, which had been designated as a support hospital during the pandemic. Patients who presented at admission or developed abnormal liver function tests in the first seven days of admission, were included in the study; patients with pre-existing liver disease, were excluded. Results: The mean (SD) age of patients included in the study was 59.41 (14.66) years with a male: female ratio of 1.51:1. Survivor status, defined as patients discharged from the intensive care unit, was significantly associated with parameters such as age, leukocyte count, albumin level, glycaemia level (p<0.05 for all parameters.) Conclusions: Liver injury expressed through liver function tests cannot solely constitute a prognostic factor for COVID-19 patients, but its presence in critically ill patients should be further investigated and included in future guideline protocols.

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