P-76 PROGNOSTIC FACTORS FOR SEVERITY AND MORTALITY IN COVID-19: ARE LIVER TESTS IMPORTANT?

Abstract

Introduction: The identification of prognostic factors related to worse outcomes in the coronavirus disease (COVID-19) is essential in the care of this challenging disease. Objectives: To identify prognostic factors that may help in decision-making related to patients’ care with COVID-19. Methods: This retrospective observational study included confirmed COVID-19 patients hospitalized in a private Brazilian hospital between March and September/2020. The following variables were analyzed: age, gender, comorbidities, admission laboratory data (leukocyte, lymphocyte and platelet count, D-dimer [DD], C-reactive protein [CRP], aspartate aminotransferase [AST], alanine aminotransferase [ALT], and total bilirubin [Bb]) and during follow-up (DD, CRP, AST, ALT, Bb). The severity of disease was evaluated according to the extension of pulmonary infiltration by CT scan at admission, classified as mild (50%), and by mechanical ventilation need. Results: 414 patients (63% males, aged 61) were included. The main comorbidities were arterial hypertension (54%) and diabetes mellitus (34%). Typical pulmonary involvement was present at admission in 318 patients: 51% mild, 39% moderate, 10% severe. 65% of patients were admitted to ICU and 25% needed mechanical ventilation. The mortality rate was 20.4%. Admission DD values (p=0.012), Bb (p=0.039), need for mechanical ventilation (p60U/L (N70U/L (N0.5mg/dL with specificity=77% and sensitivity=73%, were able to predict mortality. Conclusion: In association with well-known prognostic factors of mortality, serial measurements of aminotransferases and Bb can identify patients of greater severity and higher mortality risk.