Liver injury predicts overall mortality in severe COVID‑19: a prospective multicenter study in Brazil

dc.creatorPozzobon, Fernanda Manhães
dc.creatorPerazzo, Hugo
dc.creatorBozza, Fernando Augusto
dc.creatorRodrigues, Rosana Souza
dc.creatorPerez, Renata de Mello
dc.creatorChindamo, Maria Chiara
dc.date2021-02-11T00:14:14Z
dc.date2021-02-11T00:14:14Z
dc.date2021
dc.date.accessioned2023-09-26T20:08:05Z
dc.date.available2023-09-26T20:08:05Z
dc.identifierPOZZOBON, Fernanda Manhães et al. Liver injury predicts overall mortality in severe COVID‑19: a prospective multicenter study in Brazil. Hepatology International, p. 1-9, Feb. 2021.
dc.identifier1936-0533
dc.identifierhttps://www.arca.fiocruz.br/handle/icict/46037
dc.identifier10.1007/s12072-021-10141-6
dc.identifier.urihttps://repositorioslatinoamericanos.uchile.cl/handle/2250/8849348
dc.descriptionBackground/purpose: The relationship between liver injury and mortality remains unclear in patients with COVID-19. We aimed to evaluate the prognostic value of aminotransferases levels at hospital admission to predict mortality in patients with COVID-19. Methods and results: This prospective study included 406 patients [57% male, aged 56 years] with COVID-19 hospitalized in 26 centers in Brazil. Overall, 36.7% (95% CI 32.1–41.5) presented at admission with severe disease requiring respiratory support. The prevalence of elevated ALT and AST levels at admission [> 2 × ULN] was 14.0% (95% CI 11.0–17.8) and 12.9% (95% CI 10.0–16.6), respectively. Sixty-two patients [15.3% (95% CI 12.1–19.1)] died during hospitalization and the overall mortality rate was 13.4 (10.5–17.2) deaths per 1000 persons-years. The 15-day-overall survival (95% CI) was significantly lower in patients with ALT levels ≥ 2 × ULN compared to those with ALT < 2 × ULN [67.1% (48.4–80.2) vs 83.4% (76.1–88.6), p = 0.001] and in those with AST levels ≥ 2 × ULN compared to those with AST < 2 × ULN [61.5% (44.7–74.6) vs 84.2% (76.5–89.5), p < 0.001]. The presence of elevated aminotransferases levels at hospital admission significantly increased the risk of in-hospital all-cause mortality adjusted for age-and-sex. Those findings were present in the subgroup of critically ill patients already admitted in need of respiratory support (n = 149), but not in patients without that requirement at admission (n = 257). Conclusions: Elevated aminotransferases at hospital admission predicted in-hospital all-cause mortality in patients with COVID-19, especially in those with severe disease. Measurement of transaminases levels at hospital admission should be integrated to the care of patients with COVID-19 as an auxiliary strategy to identify patients at higher death risk.
dc.formatapplication/pdf
dc.languageeng
dc.publisherSpringer
dc.rightsopen access
dc.subjectSARS-CoV-2
dc.subjectInfection
dc.subjectAminotransferases
dc.subjectDeath
dc.subjectHepatic
dc.subjectCoronavirus
dc.subjectHospitalization
dc.subjectHospital admission
dc.subjectPrognostic value
dc.subjectSevere disease
dc.subjectRespiratory support
dc.titleLiver injury predicts overall mortality in severe COVID‑19: a prospective multicenter study in Brazil
dc.typeArticle


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