P- 17 LIVER TESTS ABNORMALITIES AS PROGNOSTIC MARKERS OF DEATH IN PATIENTS HOSPITALISED BY COVID-19. A COHORT STUDY

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A COHORT STUDY" "tieneTextoCompleto" => true "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "Andrés Fernando Rodriguez-Gutierrez, Sergio Mauricio Moreno, Camilo Andrés Duarte" "autores" => array:3 [ 0 => array:3 [ "nombre" => "Andrés Fernando" "apellidos" => "Rodriguez-Gutierrez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "1" "identificador" => "aff0001" ] ] ] 1 => array:3 [ "nombre" => "Sergio Mauricio" "apellidos" => "Moreno" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "2" "identificador" => "aff0002" ] ] ] 2 => array:3 [ "nombre" => "Camilo Andrés" "apellidos" => "Duarte" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "3" "identificador" => "aff0003" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Unidad de Medicina Interna, Hospital Universitario Nacional de Colombia, Bogotá, Colombia" "etiqueta" => "1" "identificador" => "aff0001" ] 1 => array:3 [ "entidad" => "Facultad de Medicina, Universidad de los Andes, Bogotá, Colombia" "etiqueta" => "2" "identificador" => "aff0002" ] 2 => array:3 [ "entidad" => "Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia" "etiqueta" => "3" "identificador" => "aff0003" ] ] ] ] "textoCompleto" => "<elsevierMultimedia ident="fig0001"></elsevierMultimedia>" "pdfFichero" => "main.pdf" "tienePdf" => true "tieneResumen" => true "resumen" => array:1 [ "en" => array:2 [ "resumen" => "Introduction and ObjectivesIn COVID-19, liver alterations has multiple mechanisms. The objective of this study is to evaluate if raise in transaminases and bilirubin predicts death in COVID-19. Materials and MethodsRetrospective cohort study of adults hospitalized with COVID-19 and hypoxemia. The primary outcome was death of any cause with a multivariate independent model for ALT, AST and total bilirubin adjusted by age, diabetes mellitus, presence of fever, lymphocyte count, D dimer and lactate dehydrogenase. ResultsData from 702 patients was collected. The mortality rate was 38%. In admission, 64% of patients had elevated ALT, 64% elevated AST and 8.3% elevated total bilirubin. AST rise level was independently associated with death (OR=1.06, 95% CI: 1.02-1.11 by every rise of 40 U/L, p-value=0.009). Total bilirubin also was independently associated with death (OR = 1.26, 95% CI: 1.08-1.47 for every rise in 1 mg/dl, p-value=0.003). Total bilirubin was also associated with ICU admission, mechanical ventilation and length of hospital stay. Results for ALT did not allow us to conclude an independent association with death. Age, fever and lymphocyte count nadir also was associated with death. ConclusionsIn patients with COVID-19 and hypoxemia, a rise in transaminases and bilirubin is frequent. AST and bilirubin predict mortality, so it is reasonable to measure them in admission. Progress must be made in including these markers in predictive models of mortality and clinical decision rules." 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Andrés Fernando Rodriguez-Gutierrez1, Sergio Mauricio Moreno2, Camilo Andrés Duarte3

1 Unidad de Medicina Interna, Hospital Universitario Nacional de Colombia, Bogotá, Colombia

2 Facultad de Medicina, Universidad de los Andes, Bogotá, Colombia

3 Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia

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        "resumen" => "<span id="abss0001" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0001">Introduction and Objectives</span><p id="spara001" class="elsevierStyleSimplePara elsevierViewall">In COVID-19&#44; liver alterations has multiple mechanisms&#46; The objective of this study is to evaluate if raise in transaminases and bilirubin predicts death in COVID-19&#46;</p></span> <span id="abss0002" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0002">Materials and Methods</span><p id="spara002" class="elsevierStyleSimplePara elsevierViewall">Retrospective cohort study of adults hospitalized with COVID-19 and hypoxemia&#46; The primary outcome was death of any cause with a multivariate independent model for ALT&#44; AST and total bilirubin adjusted by age&#44; diabetes mellitus&#44; presence of fever&#44; lymphocyte count&#44; D dimer and lactate dehydrogenase&#46;</p></span> <span id="abss0003" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0003">Results</span><p id="spara003" class="elsevierStyleSimplePara elsevierViewall">Data from 702 patients was collected&#46; The mortality rate was 38&#37;&#46; In admission&#44; 64&#37; of patients had elevated ALT&#44; 64&#37; elevated AST and 8&#46;3&#37; elevated total bilirubin&#46; AST rise level was independently associated with death &#40;OR&#61;1&#46;06&#44; 95&#37; CI&#58; 1&#46;02-1&#46;11 by every rise of 40 U&#47;L&#44; p-value&#61;0&#46;009&#41;&#46; Total bilirubin also was independently associated with death &#40;OR&#8239;&#61;&#8239;1&#46;26&#44; 95&#37; CI&#58; 1&#46;08-1&#46;47 for every rise in 1 mg&#47;dl&#44; p-value&#61;0&#46;003&#41;&#46; Total bilirubin was also associated with ICU admission&#44; mechanical ventilation and length of hospital stay&#46; Results for ALT did not allow us to conclude an independent association with death&#46; Age&#44; fever and lymphocyte count nadir also was associated with death&#46;</p></span> <span id="abss0004" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0004">Conclusions</span><p id="spara004" class="elsevierStyleSimplePara elsevierViewall">In patients with COVID-19 and hypoxemia&#44; a rise in transaminases and bilirubin is frequent&#46; AST and bilirubin predict mortality&#44; so it is reasonable to measure them in admission&#46; Progress must be made in including these markers in predictive models of mortality and clinical decision rules&#46;</p></span>"
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