Hepatocellular injury and the mortality risk among patients with COVID-19: A retrospective cohort study

Table 1 Baseline demographic, clinical and laboratory characteristics of alive and dead groups

Characteristics	Alive, n = 347	Dead, n = 29	Unadjusted odds ratio	P value
Age years median (IQR)			1.08 (1.05 to 1.11)	0.0001
< 40	186 (98.4)	3 (1.6)	Ref
40-60	118 (93.6)	8 (6.3)	4.8 (1.7 to 13.4)	0.003
> 60	43 (70.5)	18 (29.5)	17.6 (6.5 to 48.0)	0.0001
Male sex, n (%)	179 (92.2)	15 (7.7)	1.1 (0.6 to 2.1)	0.98
Comorbidities
Diabetes mellitus, n (%)	60 (77.0)	18 (23.0)	5.4 (2.9 to 10.2)	0.0001
Hypertension, n (%)	88 (83.8)	17 (16.2)	2.8 (1.5 to 5.2)	0.001
Ischaemic heart disease, n (%)	7 (50.0)	7 (50.0)	16.1 (5.2 to 50.2)	0.0001
Chronic kidney disease, n (%)	5 (45.5)	6 (54.5)	18.5 (5.2 to 65.5)	0.0001
Chronic respiratory disease, n (%)	57 (89.1)	7 (10.9)	1.7 (0.7 to 4.1)	0.25
Deyo–Charlson index, n (%)
0-1	281 (96.6)	10 (3.4)	Ref
2-3	64 (80.0)	16 (20.0)	7.8 (3.2 to 18.3)	0.0001
> 3	2 (40.0)	3 (60.0)	46.5 (6.9 to 313.5)	0.0001
Biochemical results on admission
Serum ALT, n (%)
< 40 U/L	225 (93.4)	16 (6.6)	Ref
40-80 U/L	98 (89.9)	11 (10.1)	1.5 (0.6 to 3.3)	0.36
> 80 U/L	24 (92.3)	2 (7.7)	1.1 (0.3 to 5.4)	0.83
Serum AST, n (%)
< 40 U/L	246 (96.8)	8 (3.2)	Ref
40-80 U/L	87 (82.3)	18 (17.1)	6.1 (2.5 to 14.7)	0.0001
> 80 U/L	14 (82.3)	3 (17.6)	6.1 (1.5 to 25.5)	0.01
AST/ALT
1.2-1.5	41 (87.2)	6 (12.7)	2.6 (1.0 to 7.2)	0.05
> 1.5	35 (81.4)	8 (18.6)	4.1 (1.6 to 10.4)	0.003
Serum albumin < 3.5 g/dL, n (%)	125 (85.6)	21 (14.4)	4.5 (1.9 to 10.5)	0.001
Serum total bilirubin > 1.5 mg/dL, n (%)	2 (33.3)	4 (66.7)	8.0 (2.2 to 29.4)	0.002
Serum creatinine > 1.1 mg/dL for males; > 0.95 mg/dL for females, n (%)	66 (77.7)	19 (22.3)	8.9 (3.9 to 20.6)	0.0001
C-reactive protein ≥ 1 mg/L, n (%)	338 (92.1)	29 (7.9)	1.0
Serum ferritin > 400 μg/L for males; > 150 μg/L for females	183 (86.7)	28 (13.3)	24.7 (3.3 to 184.1)	0.002
D-dimer > 0.5 μg/mL	335 (92.0)	29 (8.0)	1.0
Obesity (body mass index > 30)	106 (86.2)	17 (13.8)	3.2 (1.5 to 7.0)	0.003
Creatin kinase > 117 IU/L	11 (91.7)	1 (8.3)	1.1 (0.1 to 8.7)	0.9

Odds ratios were calculated by univariate logistic regression. Univariate logistic regression was used to calculate P value for the characteristics’ differences between alive and dead patients. AST: Aspartate transferase; ALT: Alanine transferase; IQR: Interquartile range; Ref: Reference.

Table 2 Odds ratios of liver injury associated mortality and 95% confidence intervals by aspartate aminotransferase categories

	Unadjusted			Model 1 (adjusted for age and sex)			Model 2
AST	OR	CI	P value	OR	CI	P value	OR	CI	P value
< 40	Ref			Ref			Ref
40-80	6.1	2.5-14.7	0.0001	4.8	1.9-12.1	0.001	10.8	2.5-40.9	0.001
> 80	6.1	1.5-25.5	0.01	2.9	0.6-13.7	0.18	12.8	1.5-93.4	0.02
						Covariates
						Age
						< 40	Ref
						40-60	1.1	0.2-6.2		0.9
						> 60	6.3	1.2-33.1		0.03
						Sex	1.1	0.4-3.7		0.7
						DM	5.7	1.0-31.7		0.04
						HTN	0.3	0.1-2.0		0.2
						IHD	5.0	0.7-37.3		0.1
						COPD	0.7	0.1-3.6		0.6
						DCI
						0-1
						2-3	0.90	0.090-9.600		0.07
						> 3	0.200	0.001-25.600		0.5
						ALT
						< 40	Ref
						40-80	0.30	0.09-1.20		0.1
						> 80	0.10	0.02-1.20		0.07
						Albumin	0.8	0.2-2.5		0.7
						Bilirubin	17.2	0.9-312.8		0.05
						Ferritin	20.7	1.7-247.0		0.01
						Creatinine	1.8	0.6-5.8		0.3
						Obesity	3.3	0.9-11.4		0.06

Adjusted odds ratios for in-hospital mortality. Model adjusted for sex and age. Model 2 adjusted for age, sex. OR: Odds ratio; CI: Confidence interval; DCI: Deyo–Charlson index; DM: Diabetes mellites; HTN: Hypertension; IHD: Ischaemic heart disease; COPD: Chronic obstructive pulmonary disease; ALT: Alanine transferase; AST: Aspartate transferase, albumin, bilirubin, ferritin, creatinine and obesity.