Abstract

This study investigated whether acute liver injury (ALI) persisted and identified predictors of ALI recovery [as indicated by alanine aminotransferase (ALT) level] at hospital discharge and 2 months post-discharge for 7595 hospitalized COVID-19 patients from the Montefiore Health System (03/11/2020–06/03/2021). Mild liver injury (mLI) was defined as ALT = 1.5–5 ULN, and severe livery injury (sLI) was ALT ≥ 5 ULN. Logistic regression was used to identify predictors of ALI onset and recovery. There were 4571 (60.2%), 2306 (30.4%), 718 (9.5%) patients with no liver injury (nLI), mLI and sLI, respectively. Males showed higher incidence of sLI and mLI (p < 0.05). Mortality odds ratio was 4.15 [95% CI 3.41, 5.05, p < 0.001] for sLI and 1.69 [95% CI 1.47, 1.96, p < 0.001] for mLI compared to nLI. The top predictors (ALT, lactate dehydrogenase, ferritin, lymphocytes) accurately predicted sLI onset up to three days prior. Only 33.5% of mLI and 17.1% of sLI patients (survivors) recovered completely at hospital discharge. Most ALI patients (76.7–82.4%) recovered completely ~ 2 months post-discharge. The top predictors accurately predicted recovery post discharge with 83.2 ± 2.2% accuracy. In conclusion, most COVID-19 patients with ALI recovered completely ~ 2 months post discharge. Early identification of patients at-risk of persistent ALI could help to prevent long-term liver complications.

Details

Title
Clinical predictors of recovery of COVID-19 associated-abnormal liver function test 2 months after hospital discharge
Author
Lu, Justin Y. 1 ; Ho, Scott L. 1 ; Buczek, Alexandra 1 ; Fleysher, Roman 1 ; Hou, Wei 2 ; Chacko, Kristina 3 ; Duong, Tim Q. 1 

 Albert Einstein College of Medicine and Montefiore Medical Center, Department of Radiology, Bronx, USA (GRID:grid.240283.f) (ISNI:0000 0001 2152 0791) 
 Stony Brook Medicine, Department of Family, Population and Preventive Medicine, Stony Brook, USA (GRID:grid.459987.e) (ISNI:0000 0004 6008 5093) 
 Albert Einstein College of Medicine and Montefiore Medical Center, Division of Hepatology, Department of Medicine, Bronx, USA (GRID:grid.240283.f) (ISNI:0000 0001 2152 0791) 
Publication year
2022
Publication date
2022
Publisher
Nature Publishing Group
e-ISSN
20452322
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2728849966
Copyright
© The Author(s) 2022. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.