HEPATIC FUNCTION ALTERATIONS IN SARS-COV 2 HOSPITALIZED PATIENTS AT HOSPITAL 450, DURANGO

Introduction and Aim

Even if Sars-Cov 2 is an emergent, primarily respiratory illness, hepatic function alterations has been described by different countries. This work aims to describe the hepatic function alterations of patients with COVID-19 and their association with comorbilities and mortality.

Material and Methods

We conducted an observational, retrospective, cross-sectional, descriptive study, using files from patients Sars-COv 2 positive PCR test admitted at Hospital 450 between March 13th through October 31st 2020, including that patients with liver function test. Sociodemographic data, symptoms, hospitalization area, outcome and laboratory results were registered. In addition, a descriptive analysis, X2 test and OR risk association were performed.

Results

466 patients were admitted at the hospital in this period of time, 69 patients without liver function test were excluded. A total of 397 patients were included: 60.2% were men, and 39.8% female. The mean age was 57 years old (16-95). 95.5% were communitary cases. Mean evolution days were 7.4 (1-37), and mean hospitalization days 8.6 (1-65). The symptoms related were: dyspnea (93.5%), cough (73%), fever (71%), myalgia (69.5%), headache (56.4%), odynophagia (27.7%), diarrhea(9.3%) and vomit (6%). Intubation were necessary in 27.2%, 28.8% had sepsis, and 15.1% were in shock status. The more frequent comorbidities were: hypertension (53%), DM (40.8%), obesity (43.1%), renal illness (14.1%) and other liver disease (3%). 33% of the patients were admitted to the intensive care unit. 63.7% demonstrated aminotransferase alterations (38% both AMT), most frequently AST (253 patients with twice normal values), hypoalbuminemia (64.7%), Alkaline Phosphatase (29.2%), and Total Bilirubin increased values (21.4%). In 61.2% of the patients anemia were detected, lymphopenia (55.4%), thrombocytopenia (17.9%), increased D dimer (79.8%), increased PCR (72.3 %). 41.1% of the patients died. Mortality association was found with: hypoalbuminemia (0.049) OR=1.548 IC95% (1.0-2.395); shock state (0.000) OR=13.995 IC95% (6.4-30.43); sepsis (0.000) OR=10.56 IC95% (6.2-17.72), intubation (0.000) OR=13.995 IC95% (12.5-45.0), renal illness (0.000) OR=5.45 IC95% (2.86-10.38), hypertension (0.000) OR=1.7 IC95% (1.13-2.55), and cardiovascular disease (0.01) OR=2.45 IC95% (1.21-4.95). No association between AMT and mortality was found.

Discussion

An elevated percentage of AMT anomalies was found, as in other works, almost one third of the patients presented with elevated AP, instead of 1.8% reported in other studies. A bad prognosis was associated with hypoalbuminemia.

Conclusions

Two thirds of the patients presented hypoalbuminemia and AMT increased, and in a few percentages with BT and AP anomalies. Hypoalbuminemia increases mortality risk.

The authors declare that there is no conflict of interest.