Impact of COVID-19 on liver function: results from an internal medicine unit in Northern Italy

• DOI: 10.1007/s11739-020-02425-w
• Publication Date: 2020-07-10T09:03:43Z
• Authors: Marco Vincenzo Lenti; Federica Borrelli...; Ivan Pellegrino; Catherine Klersy; Stefania Merli; Emanuela Miceli; Nicola Aronico; Caterina Mengoli; Michele Di Stefano; Sara Cococcia; Giovanni Santacroce; Simone Soriano; Federica Melazzini; Mariangela Dellip...; Fausto Baldanti; Antonio Triarico; Gino Roberto Corazza; Massimo Pinzani; Antonio Di Sabatino; ; Gaetano Bergamaschi; Giampiera Bertolino; Silvia Codega; Filippo Costanzo; Roberto Cresci; Giuseppe Derosa; Francesco Falaschi; Carmine Iadarola; Elisabetta Lovati; Pietro Carlo Lucotti; Alessandra Martig...; Amedeo Mugellini; Chiara Muggia; Patrizia Noris; Elisabetta Pagani; Ilaria Palumbo; Alessandro Pecci; Tiziano Perrone; Carla Pieresca; Paola Stefania Preti; Mariaconcetta Russo; Carmelo Sgarlata; Luisa Siciliani; Andrea Staniscia; Francesca Torello...; Giovanna Achilli; Andrea Agostinelli; Valentina Antoci; Alessia Ballesio; Francesco Banfi; Chiara Barteselli; Irene Benedetti; Michele Brattoli; Francesca Calabretta; Ginevra Cambiè; Roberta Canta; Federico Conca; Luigi Coppola; Elisa Maria Cremonte; Gabriele Croce; Virginia Del Rio; Francesco Di Terl...; Maria Giovanna Fe...; Sara Ferrari; Anna Fiengo; Tommaso Forni; Giulia Freddi; Chiara Frigerio; Federica Fumoso; Alessandra Fusco; Margherita Gabba; Matteo Garolfi; Antonella Gentile; Giulia Gori; Giacomo Grandi; Paolo Grimaldi; Alice Lampugnani; Francesco Lapia; Federica Lepore; Gianluca Lettieri; Jacopo Mambella; Chiara Mercanti; Francesco Mordà; Alba Nardone; Luca Pace; Lucia Padovini; Alessandro Parodi; Lavinia Pitotti; Margherita Reduzzi; Giovanni Rigano; Giorgio Rotola; Umberto Sabatini; Lucia Salvi; Giovanni Santacroce; Jessica Savioli; Simone Soriano; Carmine Spataro; Debora Stefani
• Keywords: Adult; Male; Coronaviru; Hepatiti; Pneumonia, Viral; 610; Acute respiratory failure; Hepatitis; 03 medical and health sciences; 0302 clinical medicine; Patients' Rooms; 617; Internal Medicine; Humans; Pandemics; Aged; Retrospective Studies; Aged, 80 and over; COVID-19; Middle Aged; Im - Original; 3. Good health; Coronavirus; Hospitalization; Severe acute respiratory syndrome; Italy; Liver; Emergency Medicine; Female; Coronavirus Infections; Liver Failure

AbstractLittle is known regarding coronavirus disease 2019 (COVID-19) clinical spectrum in non-Asian populations. We herein describe the impact of COVID-19 on liver function in 100 COVID-19 consecutive patients (median age 70 years, range 25–97; 79 males) who were admitted to our internal medicine unit in March 2020. We retrospectively assessed liver function tests, taking into account demographic characteristics and clinical outcome. A patient was considered as having liver injury when alanine aminotransferase (ALT) was > 50 mU/ml, gamma-glutamyl transpeptidase (GGT) > 50 mU/ml, or total bilirubin > 1.1 mg/dl. Spearman correlation coefficient for laboratory data and bivariable analysis for mortality and/or need for intensive care were assessed. A minority of patients (18.6%) were obese, and most patients were non- or moderate-drinkers (88.5%). Liver function tests were altered in 62.4% of patients, and improved during follow-up. None of the seven patients with known chronic liver disease had liver decompensation. Only one patient developed acute liver failure. In patients with altered liver function tests, PaO2/FiO2 < 200 was associated with greater mortality and need for intensive care (HR 2.34, 95% CI 1.07–5.11,p = 0.033). To conclude, a high prevalence of altered liver function tests was noticed in Italian patients with COVID-19, and this was associated with worse outcomes when developing severe acute respiratory distress syndrome.