Krishnan A, Prichett L, Tao X, Alqahtani SA, Hamilton JP, Mezey E, Strauss AT, Kim A, Potter JJ, Chen PH, Woreta TA. Abnormal liver chemistries as a predictor of COVID-19 severity and clinical outcomes in hospitalized patients. World J Gastroenterol 2022; 28(5): 570-587 [PMID: 35316959 DOI: 10.3748/wjg.v28.i5.570]
Corresponding Author of This Article
Tinsay A Woreta, MD, Assistant Professor, Division of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Hal 407, Baltimore, MD 21287, United States. tworeta1@jhmi.edu
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Feb 7, 2022; 28(5): 570-587 Published online Feb 7, 2022. doi: 10.3748/wjg.v28.i5.570
Abnormal liver chemistries as a predictor of COVID-19 severity and clinical outcomes in hospitalized patients
Arunkumar Krishnan, Laura Prichett, Xueting Tao, Saleh A Alqahtani, James P Hamilton, Esteban Mezey, Alexandra T Strauss, Ahyoung Kim, James J Potter, Po-Hung Chen, Tinsay A Woreta
Arunkumar Krishnan, Saleh A Alqahtani, James P Hamilton, Esteban Mezey, Alexandra T Strauss, Ahyoung Kim, James J Potter, Po-Hung Chen, Tinsay A Woreta, Division of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
Laura Prichett, Xueting Tao, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
Saleh A Alqahtani, Liver Transplant Center, King Faisal Specialist Hospital & Research Center, Riyadh 12713, Saudi Arabia
Author contributions: Krishnan A and Woreta TA conceptualized and designed the research; Woreta TA supervised the project; Prichett L and Tao XT performed the formal analysis; Krishnan A performed interpretation of data and writing the original draft; Krishnan A, Woreta TA, Alqahtani SA, Hamilton JP, Mezey E and Chen PH performed the review and editing of the draft; All authors revised the manuscript for important intellectual content; All authors approved the final version of the article, including the authorship list
Institutional review board statement: This study was approved by the Institutional Review Board (IRB00249001) of the Johns Hopkins University School of Medicine.
Informed consent statement: Informed consent was waived for a retrospective review of patient charts.
Conflict-of-interest statement: All the Authors have no conflict of interest related to the manuscript.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Tinsay A Woreta, MD, Assistant Professor, Division of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Hal 407, Baltimore, MD 21287, United States. tworeta1@jhmi.edu
Received: May 17, 2021 Peer-review started: May 17, 2021 First decision: July 14, 2021 Revised: July 21, 2021 Accepted: January 20, 2022 Article in press: January 20, 2022 Published online: February 7, 2022 Processing time: 252 Days and 15.2 Hours
Core Tip
Core Tip: Severe acute respiratory syndrome coronavirus-2 primarily infects the respiratory system. However, increasing evidence exists for the direct multiorgan effect. Liver injury in hospitalized patients is associated with a poor prognosis. We investigated whether abnormal liver chemistries in Coronavirus Disease 2019 (COVID-19) hospitalized patients can be of prognostic value. We show that abnormal liver chemistries were commonly observed on hospital admission and are associated with worse outcomes in COVID-19 patients, namely mortality, the need for vasopressor drugs, and mechanical ventilation. In hospitalized COVID-19 patients, elevated liver chemistries, specifically alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, and total bilirubin levels, can be used to stratify risk and predict the need for advanced therapies. These results strongly suggest that abnormal liver chemistries at the time of hospital admission are associated with worse outcomes in COVID-19 patients and should be closely followed in admitted patients.
