Prognostic Value of Transaminases and Bilirubin Levels at Admission to Hospital on Disease Progression and Mortality in Patients with COVID-19—An Observational Retrospective Study
Antonio Russo,
Mariantonietta Pisaturo,
Roberta Palladino,
Paolo Maggi,
Fabio Giuliano Numis,
Ivan Gentile,
Vincenzo Sangiovanni,
Vincenzo Esposito,
Rodolfo Punzi,
Giosuele Calabria,
Carolina Rescigno,
Angelo Salomone Megna,
Alfonso Masullo,
Elio Manzillo,
Grazia Russo,
Roberto Parrella,
Giuseppina Dell’Aquila,
Michele Gambardella,
Antonio Ponticiello,
Nicola Coppola,
on behalf of CoviCam Group
Affiliations
Antonio Russo
Infectious Diseases Unit, Department of Mental Health and Public Medicine, University of Campania “L. Vanvitelli”, 80138 Naples, Italy
Mariantonietta Pisaturo
Infectious Diseases Unit, Department of Mental Health and Public Medicine, University of Campania “L. Vanvitelli”, 80138 Naples, Italy
Roberta Palladino
Infectious Diseases Unit, Department of Mental Health and Public Medicine, University of Campania “L. Vanvitelli”, 80138 Naples, Italy
Paolo Maggi
Infectious Diseases Unit, A.O. S Anna e S Sebastiano, 81100 Caserta, Italy
Fabio Giuliano Numis
Emergency Unit, PO Santa Maria delle Grazie, 80078 Pozzuoli, Italy
Ivan Gentile
Infectious Disease Unit, University Federico II, 80138 Naples, Italy
Vincenzo Sangiovanni
Third Infectious Diseases Unit, AORN dei Colli, PO Cotugno, 80131 Naples, Italy
Vincenzo Esposito
IV Infectious Disease Unit, AORN dei Coli, PO Cotugno, 80131 Naples, Italy
Rodolfo Punzi
Hepatic Infectious Disease Unit, AORN dei Colli, PO Cotugno, 80131 Naples, Italy
Giosuele Calabria
IX Infectious Disease Unit, AORN dei Coli, PO Cotugno, 80131 Naples, Italy
Carolina Rescigno
First Infectious Disease Unit, AORN dei Coli, PO Cotugno, 80131 Naples, Italy
Angelo Salomone Megna
Infectious Diseease Unit, A.O. San Pio, PO Rummo, 82100 Benevento, Italy
Alfonso Masullo
Infectious Disease Unit, A.O. San Giovanni di Dio e Ruggi D’Aragona, 84131 Salerno, Italy
Elio Manzillo
VIII Infectious Disease Unit, AORN dei Coli, PO Cotugno, 80131 Naples, Italy
Grazia Russo
Infectious Disease Unit, Ospedale Maria S.S. Addolorata di Eboli, ASL, 84025 Salerno, Italy
Roberto Parrella
Respiratory Infectious Diseases Unit, AORN dei Colli, PO Cotugno, 80131 Naples, Italy
Giuseppina Dell’Aquila
Infectious Diseases Unit, AO, 83100 Avellino, Italy
Michele Gambardella
Infectious Diseease Unit, PO S. Luca, Vallo della Lucania, ASL, 84078 Salerno, Italy
Antonio Ponticiello
Pneumology Unit, AORN, 81100 Caserta, Italy
Nicola Coppola
Infectious Diseases Unit, Department of Mental Health and Public Medicine, University of Campania “L. Vanvitelli”, 80138 Naples, Italy
Introduction: Given the impact of COVID-19 on the world healthcare system, and the efforts of the healthcare community to find prognostic factors for hospitalization, disease progression, and mortality, the aim of the present study was to investigate the prognostic impact of transaminases and bilirubin levels at admission to hospital on disease progression and mortality in COVID-19 patients. Methods: Using the CoviCamp database, we performed a multicenter, observational, retrospective study involving 17 COVID-19 Units in southern Italy. We included all adult patients hospitalized for SARS-CoV-2 infection with at least one determination at hospital admission of aminotransaminases and/or total bilirubin. Results: Of the 2054 patients included in the CoviCamp database, 1641 were included in our study; 789 patients (48%) were considered to have mild COVID-19, 347 (21%) moderate COVID-19, 354 (22%) severe COVID-19, and 151 patients (9%) died during hospitalization. Older age (odds ratio (OR): 1.02; 95% confidence interval (CI) 1.01–1.03), higher Charlson comorbidity index (CCI) (OR 1.088; 95%CI 1.005–1.18), presence of dementia (OR: 2.20; 95% CI: 1.30–3.73), higher serum AST (OR: 1.002; 95% CI: 1.0001–1.004), and total bilirubin (OR: 1.09; 95% CI: 1.002–1.19) values were associated with a more severe clinical outcome. Instead, the 151 patients who died during hospitalization showed a higher serum bilirubin value at admission (OR 1.1165; 95% CI: 1.017–1.335); the same did not apply for AST. Discussion: Patients with COVID-19 with higher levels of AST and bilirubin had an increased risk of disease progression.
