Liver injury predicts overall mortality in severe COVID‑19: a prospective multicenter study in Brazil
| Autor(a) principal: | |
|---|---|
| Data de Publicação: | 2021 |
| Outros Autores: | , , , , |
| Tipo de documento: | Artigo |
| Idioma: | eng |
| Título da fonte: | Repositório Institucional da FIOCRUZ (ARCA) |
| Texto Completo: | https://www.arca.fiocruz.br/handle/icict/46037 |
Resumo: | Rede D’Or São Luiz. Barra D’Or Hospital. Rio de Janeiro, RJ, Brazil / Fluminense Federal University. Health Assistance Division. Niteroi, RJ, Brazil. |
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Pozzobon, Fernanda ManhãesPerazzo, HugoBozza, Fernando AugustoRodrigues, Rosana SouzaPerez, Renata de MelloChindamo, Maria Chiara2021-02-11T00:14:14Z2021-02-11T00:14:14Z2021POZZOBON, 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. 2021.1936-0533https://www.arca.fiocruz.br/handle/icict/4603710.1007/s12072-021-10141-6engSpringerLiver injury predicts overall mortality in severe COVID‑19: a prospective multicenter study in Brazilinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleRede D’Or São Luiz. Barra D’Or Hospital. Rio de Janeiro, RJ, Brazil / Fluminense Federal University. Health Assistance Division. Niteroi, RJ, Brazil.Oswaldo Cruz Foundation. Evandro Chagas National Institute of Infectious Diseases. Rio de Janeiro, RJ, Brazil.Oswaldo Cruz Foundation. Evandro Chagas National Institute of Infectious Diseases. Rio de Janeiro, RJ, Brazil / D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil.D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil.D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil / Federal University of Rio de Janeiro. Department of Internal Medicine, School of Medicine. Rio de Janeiro, RJ, Brazil.Rede D’Or São Luiz. Barra D’Or Hospital. Rio de Janeiro, RJ, Brazil / Federal University of Rio de Janeiro. Department of Internal Medicine, School of Medicine. Rio de Janeiro, RJ, Brazil.Background/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.SARS-CoV-2InfectionAminotransferasesDeathHepaticCoronavirusHospitalizationHospital admissionPrognostic valueSevere diseaseRespiratory supportinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txtlicense.txttext/plain; charset=utf-83134https://www.arca.fiocruz.br/bitstream/icict/46037/1/license.txt0ab46789d568c4ba27c7b5d29a9fe9c4MD51ORIGINALPozzobon_Fernanda_etal_INI_2021_COVID-19.pdfPozzobon_Fernanda_etal_INI_2021_COVID-19.pdfapplication/pdf738311https://www.arca.fiocruz.br/bitstream/icict/46037/2/Pozzobon_Fernanda_etal_INI_2021_COVID-19.pdf5c1412d8b92470d406339fb3be88becbMD52TEXTPozzobon_Fernanda_etal_INI_2021_COVID-19.pdf.txtPozzobon_Fernanda_etal_INI_2021_COVID-19.pdf.txtExtracted 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| dc.title.pt_BR.fl_str_mv |
Liver injury predicts overall mortality in severe COVID‑19: a prospective multicenter study in Brazil |
| title |
Liver injury predicts overall mortality in severe COVID‑19: a prospective multicenter study in Brazil |
| spellingShingle |
Liver injury predicts overall mortality in severe COVID‑19: a prospective multicenter study in Brazil Pozzobon, Fernanda Manhães SARS-CoV-2 Infection Aminotransferases Death Hepatic Coronavirus Hospitalization Hospital admission Prognostic value Severe disease Respiratory support |
| title_short |
Liver injury predicts overall mortality in severe COVID‑19: a prospective multicenter study in Brazil |
| title_full |
Liver injury predicts overall mortality in severe COVID‑19: a prospective multicenter study in Brazil |
| title_fullStr |
Liver injury predicts overall mortality in severe COVID‑19: a prospective multicenter study in Brazil |
| title_full_unstemmed |
Liver injury predicts overall mortality in severe COVID‑19: a prospective multicenter study in Brazil |
| title_sort |
Liver injury predicts overall mortality in severe COVID‑19: a prospective multicenter study in Brazil |
| author |
Pozzobon, Fernanda Manhães |
| author_facet |
Pozzobon, Fernanda Manhães Perazzo, Hugo Bozza, Fernando Augusto Rodrigues, Rosana Souza Perez, Renata de Mello Chindamo, Maria Chiara |
| author_role |
author |
| author2 |
Perazzo, Hugo Bozza, Fernando Augusto Rodrigues, Rosana Souza Perez, Renata de Mello Chindamo, Maria Chiara |
| author2_role |
author author author author author |
| dc.contributor.author.fl_str_mv |
Pozzobon, Fernanda Manhães Perazzo, Hugo Bozza, Fernando Augusto Rodrigues, Rosana Souza Perez, Renata de Mello Chindamo, Maria Chiara |
| dc.subject.en.pt_BR.fl_str_mv |
SARS-CoV-2 Infection Aminotransferases Death Hepatic Coronavirus Hospitalization Hospital admission Prognostic value Severe disease Respiratory support |
| topic |
SARS-CoV-2 Infection Aminotransferases Death Hepatic Coronavirus Hospitalization Hospital admission Prognostic value Severe disease Respiratory support |
| description |
Rede D’Or São Luiz. Barra D’Or Hospital. Rio de Janeiro, RJ, Brazil / Fluminense Federal University. Health Assistance Division. Niteroi, RJ, Brazil. |
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2021 |
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2021-02-11T00:14:14Z |
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2021-02-11T00:14:14Z |
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2021 |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
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POZZOBON, 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. |
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https://www.arca.fiocruz.br/handle/icict/46037 |
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1936-0533 |
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10.1007/s12072-021-10141-6 |
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POZZOBON, 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. 1936-0533 10.1007/s12072-021-10141-6 |
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Springer |
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