Abnormal liver chemistries as a predictor of COVID-19 severity and clinical outcomes in hospitalized patients

Table 1 Baseline and clinical characteristics of patients with a positive test for severe acute respiratory syndrome coronavirus-2

Variables	All patients (n = 3830)	Non-severe1 (n = 2476)	Severe1 (n = 1354)	P value
Age in yr, median (IQR)	64.2 (49.6- 77.3)	62.1 (45.2-76)	67.4 (55.6-79.1)	< 0.001
Sex, n (%), Male	1959 (51.1)	1179 (47.6)	780 (57.6)	< 0.001
Ethnicity, n (%), Hispanic	817 (21.5)	565 (23)	252 (18.8)	0.003
Race, n (%)				0.12
White	1389 (36.6)	877 (35.7)	512 (38.2)
Black	1323 (34.8)	848 (34.5)	475 (35.4)
Asian	203 (5.3)	133 (5.4)	70 (5.2)
Other	883 (23.2)	600 (24.4)	283 (21.1)
BMI (kg/m2), n (%)				0.11
≤ 18.5	794 (23.2)	519 (23.4)	275 (22.8)
18.5-24.9	98 (2.9)	56 (2.5)	42 (3.5)
25-29.9	1036 (30.3)	693 (31.3)	343 (28.4)
≥ 30.0	1494 (43.7)	946 (42.7)	548 (45.4)
Comorbidities, n (%)
Chronic liver disease	465 (12.1)	295 (11.9)	170 (12.6)	0.56
Cardiovascular disease
Congestive heart failure	869 (22.7)	395 (16)	474 (35)	< 0.001
HT without complications	2575 (67.2)	1766 (71.3)	717 (53)	< 0.001
HT with complications	1347 (35.2)	710 (28.7)	637 (47)	< 0.001
Diabetes
Diabetes without complications	1459 (38.1)	856 (34.6)	603 (44.5)	0.017
Diabetes with complications	1270 (33.2)	679 (27.4)	591 (43.6)	< 0.001
Chronic respiratory disease	1065 (27.8)	618 (25)	447 (33)	< 0.001
Chronic neurological disease	1033 (27.0)	569 (23)	464 (34.3)	< 0.001
CKD of any stage	973 (25.4)	491 (19.8)	482 (35.6)	< 0.001
Anemia	1655 (43.2)	906 (36.6)	749 (55.3)	< 0.001
Hypothyroidism	557 (14.5)	330 (13.3)	227 (16.8)	0.004
Malignancies
Primary cancer	458 (12)	276 (11.1)	182 (13.4)	0.036
Metastatic cancer	277 (7.2)	167 (6.7)	110 (8.1)	0.12
Laboratory findings, median (IQR)
Liver biochemistries:
ALT, median (IQR)	28 (18-47)	27 (18-45)	30 (19-49)	0.003
Normal, n (%)	1132 (29.6)	852 (34.4)	280 (20.7)
Abnormal, n (%)	2698 (70.4)	1624 (65.6)	1074 (79.3)	< 0.001
1-2 ULN, n (%)	1225 (32)	829 (33.5)	396 (29.2)
> 2-5 ULN, n (%)	1009 (26.3)	583 (23.5)	426 (31.5)
> 5 ULN, n (%)	464 (12.1)	212 (8.6)	252 (18.6)
AST, median (IQR)	36 (25-55)	34 (24-51.5)	42 (29-64)	< 0.001
Normal, n (%)	2046 (55.6)	1443 (60.5)	603 (46.4)
Abnormal, n (%)	1637 (44.4)	941 (39.5)	696 (53.6)	< 0.001
1-2 ULN, n (%)	1187 (32.2)	704 (29.5)	483 (37.2)
> 2-5 ULN, n (%)	361 (9.8)	194 (8.1)	167 (12.9)
> 5 ULN, n (%)	89 (2.4)	43 (1.8)	46 (3.5)
T.Bil, median (IQR)	0.5 (0.3-6.1)	0.4 (0.3-6.0)	0.5 (0.4-7.0)	< 0.001
Normal, n (%)	3496 (94.1)	2286 (95.3)	1210 (91.7)
Abnormal, n (%)	221 (5.9)	112 (4.7)	109 (8.3)	< 0.001
1-2 ULN, n (%)	177 (4.8)	89 (3.7)	88 (6.7)
> 2-5 ULN, n (%)	34 (0.9)	17 (0.7)	17 (1.3)
> 5 ULN, n (%)	10 (0.3)	6 (0.3)	4 (0.3)
ALP, median (IQR)	78 (61-103)	77 (61-100)	79 (61-108)	0.014
Normal, n (%)	3183 (83.9)	2101 (85.6)	1082 (80.7)
Abnormal, n (%)	611 (16.1)	353 (14.4)	258 (19.3)	< 0.001
1-2 ULN, n (%)	525 (13.8)	311 (12.7)	214 (16)
> 2-5 ULN, n (%)	78 (2.1)	38 (1.5)	40 (3)
> 5 ULN, n (%)	8 (0.2)	4 (0.2)	4 (0.3)
GGT, median (IQR)	119 (63-199)	116 (80-161)	144.5 (59-245)	0.54
Serum Albumin, g/dL median (IQR)	3.8 (3.4- 4.1)	3.9 (3.5-4.2)	3.6 (3.1-3.9)	< 0.001
Total protein (g/L), median (IQR)	6.5 (5.9- 7.1)	6.7 (6.1-7.2)	6.3 (5.7-6.9)	< 0.001
Coagulation test: median (IQR)
PT (s)	11 (10.5-11.9)	10.9 (10.4-11.6)	11.4 (10.8-12.4)	< 0.001
INR	1.07 (1-1.14)	1.05 (1.0-1.1)	1.1 (1.02-1.20)	< 0.001
APTT (s)	26.2 (1.2-32.2)	25.9 (1.1-31)	25.7 (1.3-33.6)	< 0.001
D-Dimer	1.0 (0.57, 2.06)	0.83 (0.5-1.62)	0.4 (0.8-3.0)	< 0.001
Routine blood tests: median (IQR)
Hemoglobin (g/dL)	11.9 (10.1, 13.3)	12.2 (10.7-13.6)	10.9 (9-12.7)	< 0.001
White blood cell (/mcL)	7.4 (5.1-10.5)	6.8 (4.7-9.3)	9 (6.4-13)	< 0.001
Red blood cells (/mcL)	4.06 (3.34-4.63)	4.19 (3.59-4.70)	3.81 (3.02-4.46)	< 0.001
Platelets (/mcL)	229 (168-309)	223 (166-298)	238 (172-327)	< 0.001
Neutrophils(/mcL)	36 (5.23-73)	36 (4.6-70.7)	38.9 (6.75-77.9)	< 0.001
Lymphocytes (/mcL)	15.4 (9.2-23.6)	17.8 (11.3-26.1)	11.5 (6.3-18.4)	< 0.001
Renal function tests: median (IQR)
Creatinine (mg/dL)	0.9 (0.7-1.3)	0.85 (0.7-1.1)	1.03 (0.7-1.8)	< 0.001
Blood urea nitrogen, (mmol/L)	17 (11-28)	15 (10-22)	25 (16-42)	< 0.001
Sodium (mEq/L)	138 (136-141)	138 (136-140)	139 (136-143)	< 0.001
Potassium (mEq/L)	4.1 (3.8-4.5)	4.1 (3.8-4.4)	4.2 (3.8-4.6)	< 0.001
Inflammatory markers: median (IQR)
Interleukin-6 (pg/mL)	37 (14.5-90.8)	24.7 (10.6-52.2)	81.83 (31.2-181)	< 0.001
Ferritin (ng/mL)	587 (265-1090)	482 (207-900)	810 (413.5-1462.5)	< 0.001
C reactive protein (mg/L)	8.4 (3.4-21.4)	6.4 (2.5-15.5)	13.6 (6.6-33.2)	< 0.001
Fibrinogen (mg/dL)	495 (387-622)	475 (374-579)	524 (393-653)	< 0.001
Lactate(mmol/L)	1.4 (1.1-2.0)	1.3 (1.0-1.7)	1.6 (1.2-2.3)	< 0.001
Cardiac markers: median (IQR)
Cardiac troponin I (ng/L)	0.07 (0.04-0.18)	0.05 (0.03-0.1)	0.09 (0.05-0.27)	< 0.001
Lactate dehydrogenase (U/L)	327 (245-460)	303 (229-411)	385 (290-533)	< 0.001

¹Based on the World Health Organization disease severity classification.

SARS-CoV-2: Severe acute respiratory syndrome coronavirus-2; IQR: Interquartile range; BMI: Body mass index; Fio2: Fraction of inspired oxygen; HIV/AIDS: Human immunodeficiency virus/acquired immunodeficiency síndrome; HT: Hypertension; CKD: Chronic kidney disease; ALT: Alanine aminotransferases; AST: Aspartate aminotransferase; ALP: Alkaline phosphatase; GGT: γ-glutamyl transpeptidase; T-Bil: Total bilirubin; PT: Prothrombin time; INR: International normalized ratio; APTT: Activated partial thromboplastin time; ULN: Upper limit of normal.