Impact of COVID-19 pandemic on liver, liver diseases, and liver transplantation programs in intensive care units

Table 3 Reported data on critically ill, intensive care units, or severe coronavirus disease 2019 patients

Ref.	N (all), n (severe disease). Patient population	Age (year)	Male	Pre-existing CLD	Type of pre-existing CLD	Elevated LFTs on admission (%)	LFTs levels on admission. ALT/AST/ALP/GGT (U/L)/TB (μmoL)	Selected complications or clinical outcomes
Arentz et al[56]. United States	N = 21. Critically ill	70	52%	4.8%	Cirrhosis	-	ALT: 108; AST: 273; ALP: 80; TB: 0.6 mg/dL	ALI: 14.3%; Severe ARDS: 57.1%; MV:71%; Death: 52.4%
Cai et al[34]. China	N = 318 (n = 85)1. Non-severe vs severe	47. All patients	47.5%. All patients	5%. All patients	ALD, NAFLD, HVB	ALT: 6.4% vs 21.1%; AST: 0.68% vs 18.8%; GGT: 5.1% vs 29.4%; TB: 1.2% vs 7%	-	MOF: 0% vs 11.7%
Cai et al[9]. China	N = 298 (n = 58). Non-severe vs severe	41 vs 62.5	44.1% vs 67.2%	8.3% vs 13.7%	NAFLD: 3.3% vs 10.3%; ALD: 3.3% vs 1.7%; HBV: 1.7% vs 1.7%	-	ALT: 20 vs 26.8; AST: 26 vs 36; ALP: 61 vs 58; GGT: 21 vs 35.2; TB: 10.9 vs 11.2	ALI: 9.6% vs 36.2%; Discharge: 93.3% vs 75.9%; Hospital-stay: 19 d vs 27 d; Death: 0% vs 5.2%
Du et al[57]. China	N = 109. Non-ICU vs ICU	72.7 vs 68.4	65.5% vs 70.6%	3.4% vs 0%	-	ALT: 13.8% vs 19.6%; AST: 49% vs 43.1%	ALT: 21.6 vs 27; AST: 32 vs 40	Invasive MV: 0% vs 64.7%; Hospital-stay: 12.5 d vs 15.9 d
Guan et al[40]. China	N = 1099 (n = 173). Non-severe vs severe	45 vs 52	58.2% vs 57.8%	2.4% vs 0.6%	HBV	ALT: 19.8% vs 28.1%; AST: 18.2% vs 39.4%; TB: 9.9% vs 13.3%	-	ARDS: 1.1% vs 15.6%; MV: 0% vs 38.7%; Discharge: 5.4% vs 2.9%; Hospital-stay: 11 d vs 13 d; Death: 0.1% vs 8.1%
Huang et al[2]. China	N = 41 (n = 13). Non-ICU vs ICU	49 vs 49	68% vs 85%	4% vs 0%	-	AST: 25% vs 62%	ALT: 27 vs 49; AST: 34 vs 44; TB: 10.8 vs 14	ARDS: 4% vs 85%; Shock: 0% vs 23%; Invasive MV: 0% vs 15%; Discharge: 75% vs 54%; Death: 4% vs 38%
Lei et al[28]. China	N = 5771 (n = 1186). Non-severe vs severe	55 vs 59	45.1% vs 55.3%	1.2% vs 2.1%	Viral hepatitis Cirrhosis	-	ALT: 23 vs 26; AST: 22 vs 31; ALP: 65 vs 63; TB: 10.3 vs 10.6	Reported as association not absolute values
Li et al[58]. China	N = 548 (n = 269). Non-severe vs severe	56 vs 65	45.2% vs 56.9%	1.1% vs 0.7%	HBV	ALT: 22.3% vs 24.1%; AST: 23.3% vs 43.4%; TB: 2.3% vs 6.4%	-	ALI: 15.8% vs 23%; ARDS: 9.7% vs 68%; MV: 4% vs 34.2%2; Discharge: 72.9% vs 31.7%; Death: 1.1% vs 32.5%
Mo et al[59]. China	N = 155 (n = 85)3. General vs refractory	47 vs 61	44.3% vs 64.7%	2.9% vs 5.9%	-	-	ALT: 20 vs 28; AST: 32 vs 37	Critical case: 4.3% vs 40%; MV: 0% vs 41.2%; Others reported as association
Wan et al[60]. China	N = 135 (n =40). Mild vs severe	44 vs 56	54.7% vs 52.5%	1% vs 2.5%	-	AST: 16% vs 37.5%	ALT: 21.7 vs 26.6; AST: 22.4 vs 33.6; TB: 8.6 vs 9.8	ARDS: 1.1% vs 50%; Shock: 0% vs 2.5%; Discharge: 10.5% vs 12.5%; Death: 0% vs 2.5%
Wang et al[1]. China	N = 138 (n = 36). Non-ICU vs ICU	51 vs 66	52% vs 61.1%	3.9% vs 0%	-	-	ALT: 23 vs 35; AST: 29 vs 52; TB: 9.3 vs 11.5	ARDS: 4.9% vs 61.1%; Shock: 1% vs 30.6%; Invasive MV: 0% vs 47.2%
Wu et al[42]. China	N = 201 (n = 84)4. Non-ARDS vs ARDS	48 vs 58.5	58.1% vs 71.4%	3.5%5	-	-	ALT: 27 vs 35; AST: 30 vs 38; TB: 10.5 vs 12.9	MV: 0% vs 78.6%2; Others reported as association
Zhang et al[61]. China	N = 221 (n = 55). Non-severe vs severe	51 vs 62	44% vs 63.6%	1.8% vs 7.3%	-	-	ALT: 22 vs 32; AST: 27 vs 51; TB: 9.6 vs 11.4	ARDS: 0% vs 87.3%; Shock: 0% vs 27.3%; MV: 1.2% vs 74.6%2; Discharge: 21.1% vs 12.7%; Death: 0% vs 21.8%
Zhang et al[62]. China	N = 140 (n = 58). Non-severe vs severe	51.1 vs 64	46.3% vs 56.9%	5% vs 6.9%	Fatty liver and abnormal liver function	-	-	-
Zheng et al[63]. China	N = 161 (n = 30). Non-severe vs severe	40 vs 57	50.4% vs 46.7%	3.1% vs 0%	-	ALT: 6.1% vs 16.7%; AST: 7.6% vs 40%; TB: 4.6% vs 10%	ALT: 19.3 vs 23.9; AST: 23.4 vs 31.6; TB: 10.7 vs 12.7	-

¹Total number of patients is 417 and 318 is the number for patients with liver injury (for which the comparison between severe and non-severe disease was done).

²Invasive and non-invasive mechanical ventilation.

³Reported patients with refractory and critical illness and ≥ 10 d of treatment in hospital.

⁴Subgroup of patients who developed acute respiratory distress syndrome (ARDS) after admission and those who progressed from ARDS to death.

⁵Reported for all patients.

ICU: Intensive care units; ALD: Alcoholic liver disease; ALT: Alanine aminotransferase; ALP: Alkaline phosphatase; ALI: Acute liver injury; ARDS: Acute respiratory distress syndrome; AST: Aspartate aminotransferase; CLD: Chronic liver disease; GGT: Gamma-glutamyl transpeptidase; HBV: Hepatitis B virus; LFTs: Liver function tests; MOF: Multiorgan failure; MV: Mechanical ventilation; N and n: Number of patients; NAFLD: Non-alcoholic fatty liver disease; TB: Total bilirubin.