Progressive liver injury and increased mortality risk in COVID-19 patients: A retrospective cohort study in China
Shui-Sheng Zhang, Li Dong, Gao-Ming Wang, Yuan Tian, YE Xiaofang, Yue Zhao, Zhengyin Liu, Jia-Yu Zhai, Zhiling Zhao, Junhong Wang, Huimin Zhang, Xiaolong Li, Changxin Wu, Caiting Yang, Lijuan Yang, Haixia Du, Hui Wang, Qinggang Ge, Dianrong Xiu, Ning Shen
Abstract
BACKGROUND: Liver injury is common and also can be fatal, particularly in severe or critical patients with coronavirus disease 2019 (COVID-19). AIM: To conduct an in-depth investigation into the risk factors for liver injury and into the effective measures to prevent subsequent mortality risk. METHODS: A retrospective cohort study was performed on 440 consecutive patients with relatively severe COVID-19 between January 28 and March 9, 2020 at Tongji Hospital, Wuhan, China. Data on clinical features, laboratory parameters, medications, and prognosis were collected. RESULTS: < 0.001). Using intravenous nutrition or antibiotics increased the risk of COVID-19-associated liver injury. Hepatoprotective drugs tended to be of assistance to treat the liver injury and improve the prognosis of patients with COVID-19-associated liver injury. CONCLUSION: More intensive monitoring of aspartate aminotransferase or total bilirubin is recommended for COVID-19 patients, especially patients aged ≥ 65 years, female patients, or those with other comorbidities. Drug hepatotoxicity of antibiotics and intravenous nutrition should be alert for COVID-19 patients.