Madian A, Eliwa A, Abdalla H, Aly HAA. Hepatocellular injury and the mortality risk among patients with COVID-19: A retrospective cohort study. World J Hepatol 2021; 13(8): 939-948 [PMID: 34552700 DOI: 10.4254/wjh.v13.i8.939]
Corresponding Author of This Article
Ali Madian, MSc, MD, Lecturer, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Faculty of Medicine, Al-Azhar University-Assiut, Al Walideyah Al Bahreyah, Assiut 71524, Egypt. a.madian@azhar.edu.eg
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 Hepatol. Aug 27, 2021; 13(8): 939-948 Published online Aug 27, 2021. doi: 10.4254/wjh.v13.i8.939
Hepatocellular injury and the mortality risk among patients with COVID-19: A retrospective cohort study
Ali Madian, Ahmed Eliwa, Hytham Abdalla, Haitham A Azeem Aly
Ali Madian, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Faculty of Medicine, Al-Azhar University-Assiut, Assiut 71524, Egypt
Ahmed Eliwa, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Faculty of Medicine, Al-Azhar University-Cairo, Cairo 11754, Egypt
Hytham Abdalla, Department of Chest Diseases, Faculty of Medicine, Al-Azhar University-Assiut, Assiut 71524, Egypt
Haitham A Azeem Aly, Department of Internal Medicine, Faculty of Medicine, Al-Azhar University-Assiut, Assiut 71524, Egypt
Author contributions: Madian A was responsible for study concept, design, acquisition, analysis, interpretation of data, statistical analysis and wrote draft of manuscript; Eliwa A and Abdalla H collected data; Aly HAA reviewed manuscript and provided critical scientific input; all authors approved of final manuscript draft.
Institutional review board statement: The study was approved by the ethics committee of Faculty of Medicine, Al-Azhar University, Assiut, Egypt.
Informed consent statement: No informed consent was required, as patient identity is not revealed in the retrospective analysis.
Conflict-of-interest statement: No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
Data sharing statement: The original anonymous dataset is available on request from the corresponding author at: a.madian@azhar.edu.eg.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
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: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ali Madian, MSc, MD, Lecturer, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Faculty of Medicine, Al-Azhar University-Assiut, Al Walideyah Al Bahreyah, Assiut 71524, Egypt. a.madian@azhar.edu.eg
Received: May 11, 2021 Peer-review started: May 11, 2021 First decision: June 23, 2021 Revised: July 7, 2021 Accepted: July 14, 2021 Article in press: July 14, 2021 Published online: August 27, 2021 Processing time: 100 Days and 23.5 Hours
ARTICLE HIGHLIGHTS
Research background
Clearly, infection with severe acute respiratory syndrome coronavirus 2 is not limited to the lung but also affects other organs.
Research motivation
Predictive models are needed to determine patients’ prognoses and to improve health care resource allocation during the coronavirus disease 2019 (COVID-19) pandemic.
Research objectives
To investigate whether biomarkers of hepatocellular injury at admission have prognostic value in predicting all-cause in-hospital mortality in patients with COVID-19.
Research methods
A retrospective cohort study was conducted on 376 consecutive adult patients admitted to Al-Azhar University Hospital, Assiut, Egypt and Abo Teeg General Hospital, Assiut, Egypt with confirmed COVID-19 from June 1, 2020 to July 30, 2020.
Research results
High-risk populations, especially patients aged ≥ 60 years, patients with aspartate aminotransferase (AST)-dominant liver injury or those with diabetes, should be intensively monitored. Admission serum AST and serum ferritin levels have the strongest association with the prognosis of patients with COVID-19 and can be used to monitor patients with COVID-19 at risk of liver injury.
Research conclusions
Liver injury with an AST-dominant pattern can predict the severity of COVID-19. This study confirmed an elevated level of ferritin in patients with COVID-19. Elevated serum ferritin levels are associated with in-hospital mortality.
Research perspectives
Meticulous monitoring is highly recommended for patients with COVID-19 presenting AST-dominant hepatocellular injury, especially those older than 60 years, patients with elevated serum ferritin levels or those with diabetes mellitus.
