Abnormal liver tests and non-alcoholic fatty liver disease predict disease progression and outcome of patients with COVID-19
•Abnormal liver tests at admission are associated with a poorer clinical outcome.•Patients with metabolic syndrome and NAFLD related fibrosis have a higher risk of hospitalization.•High FIB-4 index at admission may predict the risk to develop a moderate or severe disease. Coronavirus disease 2019 (C...
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| Veröffentlicht in: | Clinics and research in hepatology and gastroenterology 2022-05, Vol.46 (5), p.101894-101894, Article 101894 |
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| container_title | Clinics and research in hepatology and gastroenterology |
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| creator | Tripon, Simona Bilbault, Pascal Fabacher, Thibaut Lefebvre, Nicolas Lescuyer, Sylvain Andres, Emmanuel Schmitt, Elise Garnier-KepKA, Sabrina Borgne, Pierrick Le Muller, Joris Merdji, Hamid Chaffraix, Frédéric Mutter, Didier Baumert, Thomas F Meziani, Ferhat Doffoel, Michel |
| description | •Abnormal liver tests at admission are associated with a poorer clinical outcome.•Patients with metabolic syndrome and NAFLD related fibrosis have a higher risk of hospitalization.•High FIB-4 index at admission may predict the risk to develop a moderate or severe disease.
Coronavirus disease 2019 (COVID-19) is a serious public health issue that became rapidly pandemic. Liver injury and comorbidities, including metabolic syndrome, are associated with severe forms of the disease. This study sought to investigate liver injury, clinical features, and risk factors in patients with mild, moderate, and severe COVID-19.
We retrospectively included all consecutive patients hospitalized with laboratory-confirmed COVID-19 between February, 22 and May 15, 2020 at the emergency rooms of a French tertiary hospital. Medical history, symptoms, biological and imaging data were collected.
Among the 1381 hospitalizations for COVID-19, 719 patients underwent liver tests on admission and 496 (68.9%) patients displayed abnormal liver tests. Aspartate aminotransferase was most commonly abnormal in 57% of cases, followed by gamma-glutamyl transferase, alanine aminotransferase, albumin, alkaline phosphatase, and total bilirubin in 56.5%, 35.9%, 18.4%, 11.4%, and 5.8%. The presence of hepatocellular type more than 2xULN was associated with a higher risk of hospitalization and a worse course of severe disease (odd ratio [OR] 5.599; 95%CI: 1.27–23.86; p = 0.021; OR 3.404; 95% CI: 2.12–5.47; p |
| doi_str_mv | 10.1016/j.clinre.2022.101894 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8873041</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S2210740122000377</els_id><sourcerecordid>2634846588</sourcerecordid><originalsourceid>FETCH-LOGICAL-c463t-e6049e3fa7aa2a1d4507ec2353f15fb8c4db5976e4bdcf26237ed045427e55ad3</originalsourceid><addsrcrecordid>eNp9UctuEzEUHSEQrUr_ACEv2UzwczyzQarCo5UqdQOIneWx7zSOPHawnaBKfDxOE0LZ4I1f5557zzlN85rgBcGke7deGO9CggXFlO6f-oE_a84pJbiVnHx_fjpjctZc5rzGdXGBe0leNmdMUCoH0Z03v67GENOsPfJuBwkVyCUjHSwKMbTam7iK3hk06VIejhjrMugMaJPAOlOe3ON9gpxdDI8McVtMnAHFCW10cRAq809XVmh59-3mQ0uGV82LSfsMl8f9ovn66eOX5XV7e_f5Znl12xresdJCh_kAbNJSa6qJrTIkGMoEm4iYxt5wO4pBdsBHaybaUSbBVrGcShBCW3bRvD_wbrbjDNbUSZL2apPcrNODitqpf3-CW6n7uFN9LxnmpBK8PRKk-GNbLVKzywa81wHiNivaMd7zTvR9hfID1KSYc4Lp1IZgtc9OrdUhO7XPTh2yq2Vvno54KvqT1F8NUI3aOUgqm2qpqREkMEXZ6P7f4Te15K8_</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2634846588</pqid></control><display><type>article</type><title>Abnormal liver tests and non-alcoholic fatty liver disease predict disease progression and outcome of patients with COVID-19</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Tripon, Simona ; Bilbault, Pascal ; Fabacher, Thibaut ; Lefebvre, Nicolas ; Lescuyer, Sylvain ; Andres, Emmanuel ; Schmitt, Elise ; Garnier-KepKA, Sabrina ; Borgne, Pierrick Le ; Muller, Joris ; Merdji, Hamid ; Chaffraix, Frédéric ; Mutter, Didier ; Baumert, Thomas F ; Meziani, Ferhat ; Doffoel, Michel</creator><creatorcontrib>Tripon, Simona ; Bilbault, Pascal ; Fabacher, Thibaut ; Lefebvre, Nicolas ; Lescuyer, Sylvain ; Andres, Emmanuel ; Schmitt, Elise ; Garnier-KepKA, Sabrina ; Borgne, Pierrick Le ; Muller, Joris ; Merdji, Hamid ; Chaffraix, Frédéric ; Mutter, Didier ; Baumert, Thomas F ; Meziani, Ferhat ; Doffoel, Michel</creatorcontrib><description>•Abnormal liver tests at admission are associated with a poorer clinical outcome.•Patients with metabolic syndrome and NAFLD related fibrosis have a higher risk of hospitalization.•High FIB-4 index at admission may predict the risk to develop a moderate or severe disease.
Coronavirus disease 2019 (COVID-19) is a serious public health issue that became rapidly pandemic. Liver injury and comorbidities, including metabolic syndrome, are associated with severe forms of the disease. This study sought to investigate liver injury, clinical features, and risk factors in patients with mild, moderate, and severe COVID-19.
We retrospectively included all consecutive patients hospitalized with laboratory-confirmed COVID-19 between February, 22 and May 15, 2020 at the emergency rooms of a French tertiary hospital. Medical history, symptoms, biological and imaging data were collected.
Among the 1381 hospitalizations for COVID-19, 719 patients underwent liver tests on admission and 496 (68.9%) patients displayed abnormal liver tests. Aspartate aminotransferase was most commonly abnormal in 57% of cases, followed by gamma-glutamyl transferase, alanine aminotransferase, albumin, alkaline phosphatase, and total bilirubin in 56.5%, 35.9%, 18.4%, 11.4%, and 5.8%. The presence of hepatocellular type more than 2xULN was associated with a higher risk of hospitalization and a worse course of severe disease (odd ratio [OR] 5.599; 95%CI: 1.27–23.86; p = 0.021; OR 3.404; 95% CI: 2.12–5.47; p < 0.001, respectively). A higher NAFLD fibrosis score was associated with a higher risk of hospitalization (OR 1.754; 95%CI: 1.27–2.43, p < 0.001). In multivariate analyses, patients with high fibrosis-4 index had a 3-fold greater risk of severe disease (p < 0.001).
Abnormal liver tests are common in patients with COVID-19 and could predict the outcome. Patients with non-alcoholic fatty liver disease and liver fibrosis are at higher risk of progressing to severe COVID-19.</description><identifier>ISSN: 2210-7401</identifier><identifier>EISSN: 2210-741X</identifier><identifier>DOI: 10.1016/j.clinre.2022.101894</identifier><identifier>PMID: 35227956</identifier><language>eng</language><publisher>France: Elsevier Masson SAS</publisher><subject>COVID-19 - complications ; COVID-19 disease ; Disease Progression ; Humans ; Liver ; Liver Cirrhosis ; Liver fibrosis ; Liver function tests (LFTs) ; Liver steatosis ; Non-alcoholic Fatty Liver Disease - complications ; Non-alcoholic Fatty Liver Disease - diagnosis ; Obesity ; Original ; Retrospective Studies ; SARS-CoV-2 ; SARS-CoV-2 infection</subject><ispartof>Clinics and research in hepatology and gastroenterology, 2022-05, Vol.46 (5), p.101894-101894, Article 101894</ispartof><rights>2022 Elsevier Masson SAS</rights><rights>Copyright © 2022 Elsevier Masson SAS. All rights reserved.</rights><rights>2022 Elsevier Masson SAS. All rights reserved. 2022 Elsevier Masson SAS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c463t-e6049e3fa7aa2a1d4507ec2353f15fb8c4db5976e4bdcf26237ed045427e55ad3</citedby><cites>FETCH-LOGICAL-c463t-e6049e3fa7aa2a1d4507ec2353f15fb8c4db5976e4bdcf26237ed045427e55ad3</cites><orcidid>0000-0003-2113-2857</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S2210740122000377$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,776,780,881,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35227956$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tripon, Simona</creatorcontrib><creatorcontrib>Bilbault, Pascal</creatorcontrib><creatorcontrib>Fabacher, Thibaut</creatorcontrib><creatorcontrib>Lefebvre, Nicolas</creatorcontrib><creatorcontrib>Lescuyer, Sylvain</creatorcontrib><creatorcontrib>Andres, Emmanuel</creatorcontrib><creatorcontrib>Schmitt, Elise</creatorcontrib><creatorcontrib>Garnier-KepKA, Sabrina</creatorcontrib><creatorcontrib>Borgne, Pierrick Le</creatorcontrib><creatorcontrib>Muller, Joris</creatorcontrib><creatorcontrib>Merdji, Hamid</creatorcontrib><creatorcontrib>Chaffraix, Frédéric</creatorcontrib><creatorcontrib>Mutter, Didier</creatorcontrib><creatorcontrib>Baumert, Thomas F</creatorcontrib><creatorcontrib>Meziani, Ferhat</creatorcontrib><creatorcontrib>Doffoel, Michel</creatorcontrib><title>Abnormal liver tests and non-alcoholic fatty liver disease predict disease progression and outcome of patients with COVID-19</title><title>Clinics and research in hepatology and gastroenterology</title><addtitle>Clin Res Hepatol Gastroenterol</addtitle><description>•Abnormal liver tests at admission are associated with a poorer clinical outcome.•Patients with metabolic syndrome and NAFLD related fibrosis have a higher risk of hospitalization.•High FIB-4 index at admission may predict the risk to develop a moderate or severe disease.
Coronavirus disease 2019 (COVID-19) is a serious public health issue that became rapidly pandemic. Liver injury and comorbidities, including metabolic syndrome, are associated with severe forms of the disease. This study sought to investigate liver injury, clinical features, and risk factors in patients with mild, moderate, and severe COVID-19.
We retrospectively included all consecutive patients hospitalized with laboratory-confirmed COVID-19 between February, 22 and May 15, 2020 at the emergency rooms of a French tertiary hospital. Medical history, symptoms, biological and imaging data were collected.
Among the 1381 hospitalizations for COVID-19, 719 patients underwent liver tests on admission and 496 (68.9%) patients displayed abnormal liver tests. Aspartate aminotransferase was most commonly abnormal in 57% of cases, followed by gamma-glutamyl transferase, alanine aminotransferase, albumin, alkaline phosphatase, and total bilirubin in 56.5%, 35.9%, 18.4%, 11.4%, and 5.8%. The presence of hepatocellular type more than 2xULN was associated with a higher risk of hospitalization and a worse course of severe disease (odd ratio [OR] 5.599; 95%CI: 1.27–23.86; p = 0.021; OR 3.404; 95% CI: 2.12–5.47; p < 0.001, respectively). A higher NAFLD fibrosis score was associated with a higher risk of hospitalization (OR 1.754; 95%CI: 1.27–2.43, p < 0.001). In multivariate analyses, patients with high fibrosis-4 index had a 3-fold greater risk of severe disease (p < 0.001).
Abnormal liver tests are common in patients with COVID-19 and could predict the outcome. Patients with non-alcoholic fatty liver disease and liver fibrosis are at higher risk of progressing to severe COVID-19.</description><subject>COVID-19 - complications</subject><subject>COVID-19 disease</subject><subject>Disease Progression</subject><subject>Humans</subject><subject>Liver</subject><subject>Liver Cirrhosis</subject><subject>Liver fibrosis</subject><subject>Liver function tests (LFTs)</subject><subject>Liver steatosis</subject><subject>Non-alcoholic Fatty Liver Disease - complications</subject><subject>Non-alcoholic Fatty Liver Disease - diagnosis</subject><subject>Obesity</subject><subject>Original</subject><subject>Retrospective Studies</subject><subject>SARS-CoV-2</subject><subject>SARS-CoV-2 infection</subject><issn>2210-7401</issn><issn>2210-741X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9UctuEzEUHSEQrUr_ACEv2UzwczyzQarCo5UqdQOIneWx7zSOPHawnaBKfDxOE0LZ4I1f5557zzlN85rgBcGke7deGO9CggXFlO6f-oE_a84pJbiVnHx_fjpjctZc5rzGdXGBe0leNmdMUCoH0Z03v67GENOsPfJuBwkVyCUjHSwKMbTam7iK3hk06VIejhjrMugMaJPAOlOe3ON9gpxdDI8McVtMnAHFCW10cRAq809XVmh59-3mQ0uGV82LSfsMl8f9ovn66eOX5XV7e_f5Znl12xresdJCh_kAbNJSa6qJrTIkGMoEm4iYxt5wO4pBdsBHaybaUSbBVrGcShBCW3bRvD_wbrbjDNbUSZL2apPcrNODitqpf3-CW6n7uFN9LxnmpBK8PRKk-GNbLVKzywa81wHiNivaMd7zTvR9hfID1KSYc4Lp1IZgtc9OrdUhO7XPTh2yq2Vvno54KvqT1F8NUI3aOUgqm2qpqREkMEXZ6P7f4Te15K8_</recordid><startdate>20220501</startdate><enddate>20220501</enddate><creator>Tripon, Simona</creator><creator>Bilbault, Pascal</creator><creator>Fabacher, Thibaut</creator><creator>Lefebvre, Nicolas</creator><creator>Lescuyer, Sylvain</creator><creator>Andres, Emmanuel</creator><creator>Schmitt, Elise</creator><creator>Garnier-KepKA, Sabrina</creator><creator>Borgne, Pierrick Le</creator><creator>Muller, Joris</creator><creator>Merdji, Hamid</creator><creator>Chaffraix, Frédéric</creator><creator>Mutter, Didier</creator><creator>Baumert, Thomas F</creator><creator>Meziani, Ferhat</creator><creator>Doffoel, Michel</creator><general>Elsevier Masson SAS</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-2113-2857</orcidid></search><sort><creationdate>20220501</creationdate><title>Abnormal liver tests and non-alcoholic fatty liver disease predict disease progression and outcome of patients with COVID-19</title><author>Tripon, Simona ; Bilbault, Pascal ; Fabacher, Thibaut ; Lefebvre, Nicolas ; Lescuyer, Sylvain ; Andres, Emmanuel ; Schmitt, Elise ; Garnier-KepKA, Sabrina ; Borgne, Pierrick Le ; Muller, Joris ; Merdji, Hamid ; Chaffraix, Frédéric ; Mutter, Didier ; Baumert, Thomas F ; Meziani, Ferhat ; Doffoel, Michel</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c463t-e6049e3fa7aa2a1d4507ec2353f15fb8c4db5976e4bdcf26237ed045427e55ad3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>COVID-19 - complications</topic><topic>COVID-19 disease</topic><topic>Disease Progression</topic><topic>Humans</topic><topic>Liver</topic><topic>Liver Cirrhosis</topic><topic>Liver fibrosis</topic><topic>Liver function tests (LFTs)</topic><topic>Liver steatosis</topic><topic>Non-alcoholic Fatty Liver Disease - complications</topic><topic>Non-alcoholic Fatty Liver Disease - diagnosis</topic><topic>Obesity</topic><topic>Original</topic><topic>Retrospective Studies</topic><topic>SARS-CoV-2</topic><topic>SARS-CoV-2 infection</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tripon, Simona</creatorcontrib><creatorcontrib>Bilbault, Pascal</creatorcontrib><creatorcontrib>Fabacher, Thibaut</creatorcontrib><creatorcontrib>Lefebvre, Nicolas</creatorcontrib><creatorcontrib>Lescuyer, Sylvain</creatorcontrib><creatorcontrib>Andres, Emmanuel</creatorcontrib><creatorcontrib>Schmitt, Elise</creatorcontrib><creatorcontrib>Garnier-KepKA, Sabrina</creatorcontrib><creatorcontrib>Borgne, Pierrick Le</creatorcontrib><creatorcontrib>Muller, Joris</creatorcontrib><creatorcontrib>Merdji, Hamid</creatorcontrib><creatorcontrib>Chaffraix, Frédéric</creatorcontrib><creatorcontrib>Mutter, Didier</creatorcontrib><creatorcontrib>Baumert, Thomas F</creatorcontrib><creatorcontrib>Meziani, Ferhat</creatorcontrib><creatorcontrib>Doffoel, Michel</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Clinics and research in hepatology and gastroenterology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tripon, Simona</au><au>Bilbault, Pascal</au><au>Fabacher, Thibaut</au><au>Lefebvre, Nicolas</au><au>Lescuyer, Sylvain</au><au>Andres, Emmanuel</au><au>Schmitt, Elise</au><au>Garnier-KepKA, Sabrina</au><au>Borgne, Pierrick Le</au><au>Muller, Joris</au><au>Merdji, Hamid</au><au>Chaffraix, Frédéric</au><au>Mutter, Didier</au><au>Baumert, Thomas F</au><au>Meziani, Ferhat</au><au>Doffoel, Michel</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Abnormal liver tests and non-alcoholic fatty liver disease predict disease progression and outcome of patients with COVID-19</atitle><jtitle>Clinics and research in hepatology and gastroenterology</jtitle><addtitle>Clin Res Hepatol Gastroenterol</addtitle><date>2022-05-01</date><risdate>2022</risdate><volume>46</volume><issue>5</issue><spage>101894</spage><epage>101894</epage><pages>101894-101894</pages><artnum>101894</artnum><issn>2210-7401</issn><eissn>2210-741X</eissn><abstract>•Abnormal liver tests at admission are associated with a poorer clinical outcome.•Patients with metabolic syndrome and NAFLD related fibrosis have a higher risk of hospitalization.•High FIB-4 index at admission may predict the risk to develop a moderate or severe disease.
Coronavirus disease 2019 (COVID-19) is a serious public health issue that became rapidly pandemic. Liver injury and comorbidities, including metabolic syndrome, are associated with severe forms of the disease. This study sought to investigate liver injury, clinical features, and risk factors in patients with mild, moderate, and severe COVID-19.
We retrospectively included all consecutive patients hospitalized with laboratory-confirmed COVID-19 between February, 22 and May 15, 2020 at the emergency rooms of a French tertiary hospital. Medical history, symptoms, biological and imaging data were collected.
Among the 1381 hospitalizations for COVID-19, 719 patients underwent liver tests on admission and 496 (68.9%) patients displayed abnormal liver tests. Aspartate aminotransferase was most commonly abnormal in 57% of cases, followed by gamma-glutamyl transferase, alanine aminotransferase, albumin, alkaline phosphatase, and total bilirubin in 56.5%, 35.9%, 18.4%, 11.4%, and 5.8%. The presence of hepatocellular type more than 2xULN was associated with a higher risk of hospitalization and a worse course of severe disease (odd ratio [OR] 5.599; 95%CI: 1.27–23.86; p = 0.021; OR 3.404; 95% CI: 2.12–5.47; p < 0.001, respectively). A higher NAFLD fibrosis score was associated with a higher risk of hospitalization (OR 1.754; 95%CI: 1.27–2.43, p < 0.001). In multivariate analyses, patients with high fibrosis-4 index had a 3-fold greater risk of severe disease (p < 0.001).
Abnormal liver tests are common in patients with COVID-19 and could predict the outcome. Patients with non-alcoholic fatty liver disease and liver fibrosis are at higher risk of progressing to severe COVID-19.</abstract><cop>France</cop><pub>Elsevier Masson SAS</pub><pmid>35227956</pmid><doi>10.1016/j.clinre.2022.101894</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0003-2113-2857</orcidid><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 2210-7401 |
| ispartof | Clinics and research in hepatology and gastroenterology, 2022-05, Vol.46 (5), p.101894-101894, Article 101894 |
| issn | 2210-7401 2210-741X |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8873041 |
| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | COVID-19 - complications COVID-19 disease Disease Progression Humans Liver Liver Cirrhosis Liver fibrosis Liver function tests (LFTs) Liver steatosis Non-alcoholic Fatty Liver Disease - complications Non-alcoholic Fatty Liver Disease - diagnosis Obesity Original Retrospective Studies SARS-CoV-2 SARS-CoV-2 infection |
| title | Abnormal liver tests and non-alcoholic fatty liver disease predict disease progression and outcome of patients with COVID-19 |
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