Journal of Clinical Medicine (Aug 2022)
Liver Function Tests in COVID-19: Assessment of the Actual Prognostic Value
- Urszula Tokarczyk,
- Krzysztof Kaliszewski,
- Anna Kopszak,
- Łukasz Nowak,
- Karolina Sutkowska-Stępień,
- Maciej Sroczyński,
- Monika Sępek,
- Agata Dudek,
- Dorota Diakowska,
- Małgorzata Trocha,
- Damian Gajecki,
- Jakub Gawryś,
- Tomasz Matys,
- Justyna Maciejiczek,
- Valeriia Kozub,
- Roman Szalast,
- Marcin Madziarski,
- Anna Zubkiewicz-Zarębska,
- Krzysztof Letachowicz,
- Katarzyna Kiliś-Pstrusińska,
- Agnieszka Matera-Witkiewicz,
- Michał Pomorski,
- Marcin Protasiewicz,
- Janusz Sokołowski,
- Barbara Adamik,
- Krzysztof Kujawa,
- Adrian Doroszko,
- Katarzyna Madziarska,
- Ewa Anita Jankowska
Affiliations
- Urszula Tokarczyk
- Clinical Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
- Krzysztof Kaliszewski
- Clinical Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
- Anna Kopszak
- Statistical Analysis Center, Wroclaw Medical University, Marcinkowski Street 2-6, 50-368 Wroclaw, Poland
- Łukasz Nowak
- Clinical Department of Urology and Urological Oncology, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
- Karolina Sutkowska-Stępień
- Clinical Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
- Maciej Sroczyński
- Clinical Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
- Monika Sępek
- Clinical Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
- Agata Dudek
- Clinical Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
- Dorota Diakowska
- Department of Basic Science, Faculty of Health Science, Wroclaw Medical University, Bartel Street 5, 51-618 Wroclaw, Poland
- Małgorzata Trocha
- Department of Pharmacology, Wroclaw Medical University, Mikulicz-Radecki Street 2, 50-345 Wroclaw, Poland
- Damian Gajecki
- Clinical Department of Internal and Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland
- Jakub Gawryś
- Clinical Department of Internal and Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland
- Tomasz Matys
- Clinical Department of Internal and Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland
- Justyna Maciejiczek
- Clinical Department of Internal Medicine, Pneumology and Allergology, Wroclaw Medical University, M. Skłodowskiej-Curie Street 66, 50-369 Wroclaw, Poland
- Valeriia Kozub
- Clinical Department of Internal Medicine, Pneumology and Allergology, Wroclaw Medical University, M. Skłodowskiej-Curie Street 66, 50-369 Wroclaw, Poland
- Roman Szalast
- Clinical Department of Internal Medicine, Pneumology and Allergology, Wroclaw Medical University, M. Skłodowskiej-Curie Street 66, 50-369 Wroclaw, Poland
- Marcin Madziarski
- Clinical Department of Rheumatology and Internal Medicine, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
- Anna Zubkiewicz-Zarębska
- Clinical Department of Gastroenterology and Hepatology, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
- Krzysztof Letachowicz
- Clinical Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
- Katarzyna Kiliś-Pstrusińska
- Clinical Department of Pediatric Nephrology, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
- Agnieszka Matera-Witkiewicz
- Screening Laboratory of Biological Activity Assays and Collection of Biological Material, Faculty of Pharmacy, Wroclaw Medical University, Borowska Street 211A, 50-556 Wroclaw, Poland
- Michał Pomorski
- Clinical Department of Gynecology and Obstetrics, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
- Marcin Protasiewicz
- Clinical Department and Clinic of Cardiology, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
- Janusz Sokołowski
- Department of Emergency Medicine, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
- Barbara Adamik
- Clinical Department of Anaesthesiology and Intensive Therapy, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
- Krzysztof Kujawa
- Statistical Analysis Center, Wroclaw Medical University, Marcinkowski Street 2-6, 50-368 Wroclaw, Poland
- Adrian Doroszko
- Clinical Department of Internal and Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland
- Katarzyna Madziarska
- Clinical Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
- Ewa Anita Jankowska
- University Hospital in Wroclaw, Institute of Heart Diseases, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
- DOI
- https://doi.org/10.3390/jcm11154490
- Journal volume & issue
-
Vol. 11,
no. 15
p. 4490
Abstract
Deviations in laboratory tests assessing liver function in patients with COVID-19 are frequently observed. Their importance and pathogenesis are still debated. In our retrospective study, we analyzed liver-related parameters: aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), gamma-glutamyltransferase (GGT), total bilirubin (TBIL), albumin, comorbidities and other selected potential risk factors in patients admitted with SARS-CoV-2 infection to assess their prognostic value for intensive care unit admission, mechanical ventilation necessity and mortality. We compared the prognostic effectiveness of these parameters separately and in pairs to the neutrophil-to-lymphocyte ratio (NLR) as an independent risk factor of in-hospital mortality, using the Akaike Information Criterion (AIC). Data were collected from 2109 included patients. We created models using a sample with complete laboratory tests n = 401 and then applied them to the whole studied group excluding patients with missing singular variables. We estimated that albumin may be a better predictor of the COVID-19-severity course compared to NLR, irrespective of comorbidities (p p = 0.008) or TBIL (OR 1.657, p = 0.001) creates excellent prediction models for in-hospital mortality. In conclusion, the early evaluation of albumin levels and liver-related parameters may be indispensable tools for the early assessment of the clinical course of patients with COVID-19.
Keywords