Acute Liver Injury in COVID‐19: Prevalence and Association with Clinical Outcomes in a Large U.S. Cohort

• DOI: 10.1002/hep.31404
• Publication Date: 2020-05-30T21:52:46Z
• Authors: Meaghan M. Phipps; Luis H. Barraza; Elijah D. LaSota; Magdalena E. Sobi...; Marcus R. Pereira; Elizabeth X. Zheng; Alyson N. Fox; Jason Zucker; Elizabeth C. Verna
• Keywords: 2019-20 coronavirus outbreak

Background and Aims Coronavirus disease 2019 (COVID‐19) has been associated with acute liver injury (ALI) manifested by increased enzymes in reports worldwide. Prevalence of clinical characteristics are not well defined. We aim to identify the prevalence risk factors for development COVID‐19‐associated ALI a large cohort United States. Approach Results In this retrospective study, all patients who underwent SARS‐CoV‐2 testing at three hospitals NewYork‐Presbyterian network were assessed. Of 3,381 patients, 2,273 tested positive had higher initial peak alanine aminotransferase (ALT) than those negative. was categorized as mild if ALT greater upper limit normal (ULN) but <2 times ULN, moderate between 2 5 severe >5 ULN. Among positive, 45% mild, 21% moderate, 6.4% (SLI). multivariable analysis, significantly elevated inflammatory markers, including ferritin (odds ratio [OR], 2.40; P < 0.001) interleukin‐6 (OR, 1.45; = 0.009). Patients SLI more course, rates intensive care unit admission (69%), intubation (65%), renal replacement therapy (RRT; 33%), mortality (42%). death or discharge hospice 1.14; 0.044), controlling age, body mass index, diabetes, hypertension, intubation, RRT. Conclusions is common test SARS‐CoV‐2, most often mild. However, among SLI, course should be anticipated.