Infection and Drug Resistance (Aug 2021)

Abnormal Indexes of Liver and Kidney Injury Markers Predict Severity in COVID-19 Patients

  • Qu J,
  • Zhu HH,
  • Huang XJ,
  • He GF,
  • Liu JY,
  • Huang JJ,
  • Chen Y,
  • Qu Q,
  • Wu YL,
  • Chen XY,
  • Lu Q

Journal volume & issue
Vol. Volume 14
pp. 3029 – 3040

Abstract

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Jian Qu,1,* Hai-Hong Zhu,1,* Xue-Jian Huang,1 Ge-Fei He,2 Ji-Yang Liu,2 Juan-Juan Huang,2 Ying Chen,3 Qiang Qu,4 Ya-Li Wu,5 Xiang-Yu Chen,6 Qiong Lu1 1Department of Pharmacy, the Second Xiangya Hospital, Central South University; Institute of Clinical Pharmacy, Central South University, Changsha, 410011, People’s Republic of China; 2Department of Pharmacy, The First Hospital of Changsha, Changsha, 410005, People’s Republic of China; 3Department of Pharmacy, Wuhan University, Renmin Hospital, Wuhan, 430060, People’s Republic of China; 4Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, 410007, People’s Republic of China; 5Department of Pharmacy, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, 410000, People’s Republic of China; 6Department of Radiology, the Second Xiangya Hospital, Central South University, Changsha, 410011, People’s Republic of China*These authors contributed equally to this workCorrespondence: Qiong LuDepartment of Pharmacy, the Second Xiangya Hospital, Central South University; Institute of Clinical Pharmacy, Central South University, 139 Middle Renmin Road, Changsha, Hunan, 410011, People’s Republic of ChinaTel +86-731-85292072Fax +86-731-85533525Email [email protected]: SARS-CoV-2 can damage not only the lungs but also the liver and kidney. Most critically ill patients with coronavirus disease 2019 (COVID-19) have liver and kidney dysfunction. We aim to investigate the levels of liver and kidney function indexes in mild and severe COVID-19 patients and their capability to predict the severity of the disease.Methods: The characteristics and laboratory indexes were compared between patients with different conditions. We applied binary logistic regression to find the independent risk factors of severe patients. Receiver operating characteristic (ROC) analysis was used to predict the severity of COVID-19 using the liver and kidney function indexes.Results: This study enrolled 266 COVID-19 patients, including 235 mild patients and 31 severe patients. Compared with mild patients, severe patients had lower albumin (ALB) and higher alanine aminotransferase (ALT), aspartate aminotransferase (AST), and urea nitrogen (BUN) (all p< 0.001). Binary logistic regression analysis also identified ALB [OR=0.273 (0.079– 0.947), p=0.041] and ALT [OR=2.680 (1.036– 6.934), p=0.042] as independent factors of severe COVID-19 patients. Combining ALB, ALT, BUN, and LDH exhibited the area under ROC at 0.914, with a sensitivity of 86.7% and specificity of 83.0%.Conclusion: COVID-19 patients, especially severe patients, have damage to liver and kidney function. ALT, AST, LDH, and BUN could be independent factors for predicting the severity of COVID-19. Combining the ALB, ALT, BUN, and LDH could predict the transition from mild to severe in COVID-19 patients.Keywords: COVID-19, liver damage, kidney damage, predictor of disease severity

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