Retrospective Cohort Study
Copyright ©The Author(s) 2022.
World J Gastroenterol. Oct 21, 2022; 28(39): 5735-5749
Published online Oct 21, 2022. doi: 10.3748/wjg.v28.i39.5735
Table 1 Characteristics of the studied patients
Variables
Group 1 (with elevated liver enzymes)
Group 2 (with normal liver enzymes)
P value

Number of tested

Number of tested
n/%603/88.260381/11.881
Male, n/%356/59.035628/34.628< 0.0001
Female, n/%247/41.024753/65.453
Age, yr ± SD50.7 ± 9.560351.9 ± 12.4810.5075
Hospitalization, d ± SD9.7 ± 5.96038.7 ± 6.5810.2039
ALT, U/L, range149 ± 115, 40-72860322 ± 9, 7-3981< 0.0001
AST, U/L, range90 ± 77, 3-81855222 ± 7, 11-3970< 0.0001
GGT, U/L, range114 ± 125, 8-82055022 ± 8, 7-3572< 0.0001
ALP, U/L, range101 ± 128, 29-11839377 ± 25, 45-131100.128
Bilirubin, μmol/L, range9.1 ± 5.5, 3-67.14607.6 ± 3.2, 3.2-18.5610.0028
SPA, %, range96.1 ± 19.5, 5-17650098.6 ± 21.9, 39-154640.3868
INR, range1.04 ± 0.18, 0.83-3.875061.03 ± 0.11, 0.86-1.6680.4728
Table 2 Coronavirus disease 2019 pneumonia severity indices of patients with elevated liver enzymes (group 1) versus normal liver enzymes (group 2)

Group 1 (n = 603)
Group 2 (n = 81)
P value


Number of tested

Number of tested

Moderate COVID, n/%436/72.260364/79.0810.4341
Severe COVID, n/%134/22.414/17.3
Critical COVID, n/%33/5.43/3.7
O2 demand, n/%188/31.260321/25.9810.3354
SpO2, %, range94.4 ± 3.5, 68-10059495.3 ± 2.9, 84-99760.0169
Respiratory rate, n/min, range18.4 ± 3.2, 14-4054317.7 ± 2.4, 14-28720.0291
Mortality, total, n/%17/2.86033/3.7810.6573
CRP, mg/L, range72.3 ± 68.9, 0.4-459.057154.2 ± 56.1, 0.6-327.0700.0151
IL-6, ng/L, range50.3 ± 120.0, 3-249954635.7 ± 38.9, 2-188650.0402
LDH, U/L, range357.9 ± 134.0, 167-979435299.0 ± 173.4, 134-1304490.0254
Table 3 Comparison of coronavirus disease 2019 pneumonia complications in patients with (group 1) and without (group 2) elevated liver enzymes

Group 1
Group 2
P value
Bacterial complication, n/%335/55.634/42.00.0213
Sepsis, n/%14/2.34/4.90.1672
Respiratory failure, n/%63/10.47/8.60.6146
Acid-alkaline imbalance, n/%11/1.800.2204
Electrolyte imbalance, n/%67/11.18/9.90.7385
Hyperkalemia, n/%10/1.700.2426
Hypokalemia, n/%40/6.67/8.60.5023
Hypernatremia, n/%1/0.22/2.50.0032
Hyponatremia, n/%13/2.200.1821
Blood volume decrease, n/%15/2.53/3.70.5209
Blood clotting disorder, n/%6/1.03/3.70.0446
Acute kidney failure, n/%15/2.51/1.20.4836
Acute liver failure, n/%5/0.800.3672
Antibiotic resistance, n/%18/3.01/1.20.3681
Table 4 Prevalence of underlying diseases in patients with (group 1) and without (group 2) elevated liver enzymes

Group 1
Group 2
P value
Hospitalization, d, n ± SD9.7 ± 5.98.7 ± 6.50.2039
Primary hypertension, n/%193/32.021/25.90.2638
Heart disease, n/%32/5.36/7.40.4430
Lung disease, n/%19/3.25/6.20.1652
Diabetes, n/%50/8.39/11.10.4015
Obesity, n/%14/2.33/3.70.4532
Hyperlipidemia, n/%31/5.15/6.20.6962
Podagra, n/%12/2.000.2002
Kidney disease, n/%16/2.74/4.90.2518
Prostate disease, n/%9/1.51/1.20.8546
Urinary tract disease, n/%39/6.56/7.40.7487
Thyroiditis and goiter, n/%21/3.54/4.90.5121
Gastrointestinal disease, n/%32/5.33/3.70.5387
Liver disease, n/%22/3.72/2.50.5865
Nervous and mental diseases, n/%27/4.51/1.20.1666
Cancers, n/%17/2.85/6.20.1098
Table 5 The association of the severity of coronavirus pneumonia with the demographic characteristics of patients and critical disease outcomes (data from univariate logistic regression analysis)

OR
95% confidence interval
P value
Gender: male vs female1.59891371.1317308-2.27327600.0083
Age1.02602751.0116249-1.04094740.0004
Respiratory rate1.15888821.0942282-1.2311821< 0.0001
Acute respiratory failure3.31148842.0001907-5.4967193< 0.0001
O2 demand3.94760282.7654860-5.6573094< 0.0001
Sepsis7.48255812.7778683-23.6019330.0002
Acute kidney failure6.25862072.2427771-20.0970890.0008
Antibiotic resistance3.88793101.5485304-10.1930770.0041
Mortality26.83832237.6407747-169.97850< 0.0001
Table 6 The association of the severity of coronavirus pneumonia with underlying diseases (data from univariate logistic regression analysis)

OR
95% confidence interval
P value
Diabetes2.30417381.3274753-3.96429710.0027
Heart disease2.57604791.3198252-4.99607470.0050
Hyperlipidemia2.28571401.1426635-4.50484340.0173
Table 7 Independent factors associated with the severity of coronavirus disease 2019 (data from multivariate logistic regression analysis)

OR
95% confidence interval
P value
Age1.02279241.0032076-1.04315640.0234
Gender: male vs female1.72335751.1114172-2.70175070.0161
Respiratory rate1.14448041.0724480-1.2254639< 0.0001
Respiration failure2.18789061.1163265-4.23842660.0209
Sepsis14.9236041.6112025-359.534330.0352
Diabetes3.22063351.5539799-6.68347590.0016
Hyperlipidemia2.66526391.1327787-6.27940950.0238
Table 8 Data from patients with acute liver failure
Gender
Age
Outcome
COVID severity
Respiratory failure, SpO2, respiratory rate
O2
Laboratory tests
COVID complications
Comorbidities
Male84DeceasedCriticalYes, 83%, 18/minNoALT 107, ALP 117, GGT 107, LDH 743, Alb 29.3Sepsis; Electrolytes imbalance; Hypokalemia; Acid-alkaline imbalanceHeart disease; Epilepsy
Male55DeceasedCriticalYes, 91%, 34/minYesCRP 111, IL-6 87, ALT 115, AST 344, ALP 40, LDH 448, Alb 28.1Sepsis; Hypokalemia; Hyponatremia; Blood coagulation disorderPrimary hypertension; Obesity; Antibiotic resistance
Male44RecoveredModerateNo, 94%, 16/minNoCRP 98, IL-6 54, ALT 113, AST 193, ALP 73, GGT 355, LDH 399HypokalemiaPrimary hypertension; Heart disease; Kidney disease
Male42DeceasedCriticalYes, 80%, 30/minYesCRP 459, IL-6 99, ALT 162, AST 183, ALP 1183, GGT 67, LDH 900, Alb 16.6Acute kidney failure; Sepsis; Bacterial pneumonia complication; Hypokalemia; Blood coagulation disorderUrinary tract infection; Anemia; Antibiotic resistance
Male50DeceasedModerateNo, 98%, 22/minNoCRP 221, IL-6 626, ALT 521, AST 53, ALP 296, GGT 559, LDH 546, Alb 16.5Acute kidney failure; Sepsis; Blood coagulation disorder; HypokalemiaHeart disease; Cancer (lymphoma)
Table 9 Analysis of patients hospitalized with coronavirus disease 2019 depending on the outcome of the disease

Deceased
Recovered
P value
Total number, n/%20/2.9664/97.1
Male/female ratio17/3367/2970.0081
Age, yr ± SD64.3±11.950.450.0004
With normal enzymes, n/%3/15.078/11.70.6554
With elevated enzymes, n/%17/85.0586/88.3
Moderate COVID, n/%2/10.0498/75.0< 0.0001
Severe COVID, n/%5/25.0143/21.5
Critical COVID, n/%13/65.023/3.5
Respiratory failure, n/%17/85.053/8.0< 0.0001
Respiratory rate, n/min ± SD22.3 ± 5.618.2 ± 2.90.0099
SpO2, % ± SD88.7 ± 6.394.6 ± 3.20.0010
O2 demand, n/%11/55.0198/29.80.0158
Bacterial pneumonia complication, n/%5/25.0364/54.80.0084
Sepsis, n/%13/65.05/0.8< 0.0001
Acute liver failure, n/%4/20.01/0.15< 0.0001
Acute kidney failure, n/%10/50.06/0.9< 0.0001
Electrolytes imbalance, n/%11/55.064/9.6< 0.0001
Antibiotic resistance, n/%7/35.012/1.8< 0.0001
Urinary tract infections, n/%5/25.040/6.00.0007
Primary hypertension, n/%10/50.0204/30.70.0669
Heart disease, n/%10/50.028/4.2< 0.0001