Journal of Multidisciplinary Healthcare (Mar 2021)

Risk Factors and Prognosis in Patients with COVID-19 and Liver Injury: A Retrospective Analysis

  • Shen JX,
  • Zhuang ZH,
  • Zhang QX,
  • Huang JF,
  • Chen GP,
  • Fang YY,
  • Cheng AG

Journal volume & issue
Vol. Volume 14
pp. 629 – 637

Abstract

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Jia-Xin Shen,1 Ze-Hao Zhuang,1 Qiao-Xian Zhang,2 Jiao-Feng Huang,3 Gong-Ping Chen,4 Ying-Ying Fang,5 Ai-Guo Cheng6 1Endoscopy Center, First Affiliated Hospital of Fujian Medical University, Fuzhou, People’s Republic of China; 2Nursing Department, First Affiliated Hospital of Fujian Medical University, Fuzhou, People’s Republic of China; 3Department of Liver Research Center, First Affiliated Hospital of Fujian Medical University, Fuzhou, People’s Republic of China; 4Department of Pulmonary and Critical Care Medicine, First Affiliated Hospital of Fujian Medical University, Fuzhou, People’s Republic of China; 5Department of Tuberculosis, Third People’s Hospital of Yichang, Yichang, People’s Republic of China; 6Department of Critical Care, Third People’s Hospital of Yichang, Yichang, People’s Republic of ChinaCorrespondence: Ze-Hao ZhuangEndoscopy Center, First Affiliated Hospital of Fujian Medical University, 20, Chazhong Road, Taijiang District, Fuzhou, 350005, Fujian Province, People’s Republic of ChinaTel +86-131-7803-2412Fax +89-59187981370Email [email protected]: COVID-19 is a new infectious disease with global spread. The aim of the present study was to explore possible risk factors and evaluate prognosis in COVID-19 with liver injury.Methods: A retrospective study was conducted on 356 COVID-19 patients in the Third People’s Hospital of Yichang, Hubei, China. Clinical characteristics and laboratory tests between patients with and without liver injury were compared, while risk factors of COVID-19–related liver injury were analyzed. Univariate and multivariate Cox regression analyses were conducted to identify risk factors of in-hospital death.Results: Of the patients with liver injury, severe and critical types of COVID-19 comprised 12.43% and 14.69%, respectively, higher than in patients without liver injury (both P< 0.05). CRP and male sex were independent risk factors for for patients with liver injury, while decreased lymphocyte count (HR 0.024, 95% CI 0.001– 0.821) and elevated monocytes (HR 1.951, 95% CI 1.040– 3.662) and CRP (HR 1.028, 95% CI 1.010– 1.045) were independent risk factors of prognosis of death in COVID-19 patients with liver injury.Conclusion: Liver injury is a common complication in severe COVID-19 patients. Male sex and elevated CRP were independent risk factors in COVID-19 complicated by liver damage. Liver damage with increased CRP and monocyte count and decreased lymphocyte count may imply a poor prognosis.Keywords: COVID-19, liver injury, risk factors, prognosis

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