| Author | Pozzobon, Fernanda Manhães | |
| Author | Perazzo, Hugo | |
| Author | Bozza, Fernando A. | |
| Author | Rodrigues, Rosana Souza | |
| Author | Perez, Renata de Mello | |
| Author | Chindamo, Maria Chiara | |
| Access date | 2021-02-11T00:14:14Z | |
| Available date | 2021-02-11T00:14:14Z | |
| Document date | 2021 | |
| Citation | POZZOBON, Fernanda Manhães et al. Liver injury predicts overall mortality in severe COVID‑19: a prospective multicenter study in Brazil. Hepatology International, v. 15, n. 2, p. 493-501, Apr. 2021. | pt_BR |
| ISSN | 1936-0533 | pt_BR |
| URI | https://www.arca.fiocruz.br/handle/icict/46037 | |
| Language | eng | pt_BR |
| Publisher | Springer | pt_BR |
| Rights | open access | pt_BR |
| Title | Liver injury predicts overall mortality in severe COVID‑19: a prospective multicenter study in Brazil | pt_BR |
| Type | Article | pt_BR |
| DOI | 10.1007/s12072-021-10141-6 | |
| Abstract | Background/purpose: The relationship between liver injury and mortality remains unclear in patients with COVID-19. We aimed to evaluate the prognostic value of aminotransferases levels at hospital admission to predict mortality in patients with COVID-19. Methods and results: This prospective study included 406 patients [57% male, aged 56 years] with COVID-19 hospitalized in 26 centers in Brazil. Overall, 36.7% (95% CI 32.1–41.5) presented at admission with severe disease requiring respiratory support. The prevalence of elevated ALT and AST levels at admission [> 2 × ULN] was 14.0% (95% CI 11.0–17.8) and 12.9% (95% CI 10.0–16.6), respectively. Sixty-two patients [15.3% (95% CI 12.1–19.1)] died during hospitalization and the overall mortality rate was 13.4 (10.5–17.2) deaths per 1000 persons-years. The 15-day-overall survival (95% CI) was significantly lower in patients with ALT levels ≥ 2 × ULN compared to those with ALT < 2 × ULN [67.1% (48.4–80.2) vs 83.4% (76.1–88.6), p = 0.001] and in those with AST levels ≥ 2 × ULN compared to those with AST < 2 × ULN [61.5% (44.7–74.6) vs 84.2% (76.5–89.5), p < 0.001]. The presence of elevated aminotransferases levels at hospital admission significantly increased the risk of in-hospital all-cause mortality adjusted for age-and-sex. Those findings were present in the subgroup of critically ill patients already admitted in need of respiratory support (n = 149), but not in patients without that requirement at admission (n = 257). Conclusions: Elevated aminotransferases at hospital admission predicted in-hospital all-cause mortality in patients with COVID-19, especially in those with severe disease. Measurement of transaminases levels at hospital admission should be integrated to the care of patients with COVID-19 as an auxiliary strategy to identify patients at higher death risk. | pt_BR |
| Affilliation | Rede D’Or São Luiz. Barra D’Or Hospital. Rio de Janeiro, RJ, Brazil / Fluminense Federal University. Health Assistance Division. Niteroi, RJ, Brazil. | pt_BR |
| Affilliation | Oswaldo Cruz Foundation. Evandro Chagas National Institute of Infectious Diseases. Rio de Janeiro, RJ, Brazil. | pt_BR |
| Affilliation | Oswaldo Cruz Foundation. Evandro Chagas National Institute of Infectious Diseases. Rio de Janeiro, RJ, Brazil / D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil. | pt_BR |
| Affilliation | D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil. | pt_BR |
| Affilliation | D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil / Federal University of Rio de Janeiro. Department of Internal Medicine. School of Medicine. Rio de Janeiro, RJ, Brazil. | pt_BR |
| Affilliation | Rede D’Or São Luiz. Barra D’Or Hospital. Rio de Janeiro, RJ, Brazil / Federal University of Rio de Janeiro. Department of Internal Medicine. School of Medicine. Rio de Janeiro, RJ, Brazil. | pt_BR |
| Subject | SARS-CoV-2 | pt_BR |
| Subject | Infection | pt_BR |
| Subject | Aminotransferases | pt_BR |
| Subject | Death | pt_BR |
| Subject | Hepatic | pt_BR |
| Subject | Coronavirus | pt_BR |
| Subject | Hospitalization | pt_BR |
| Subject | Hospital admission | pt_BR |
| Subject | Prognostic value | pt_BR |
| Subject | Severe disease | pt_BR |
| Subject | Respiratory support | pt_BR |
