Retrospective Cohort Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 14, 2021; 27(42): 7350-7361
Published online Nov 14, 2021. doi: 10.3748/wjg.v27.i42.7350
Presentation, patterns and predictive value of baseline liver tests on outcomes in COVID-19 patients without chronic liver disease
David Bernstein, Nitzan Roth, Angela Kim, Marcia Epstein, David Hirschwerk, Charlotte L Kvasnovsky, Sanjaya K Satapathy
David Bernstein, Nitzan Roth, Sanjaya K Satapathy, Department of Medicine/Hepatology, Northwell Health, Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY 11030, United States
Angela Kim, Marcia Epstein, David Hirschwerk, Division of Infectious Diseases, Department of Medicine Northwell Health, Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY 11030, United States
Charlotte L Kvasnovsky, Cohen Children's Medical Center, Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY 11042, United States
Author contributions: Bernstein D, Roth N, and Satapathy SK developed the concept for the manuscript; Bernstein D wrote the manuscript; Kvasnovsky CL performed the statistical analysis; Kim A, Epstein M, and Hirschwerk D reviewed the literature; Bernstein D, Satapathy S, Roth N, Kim A, Epstein M, Hirschwerk D, and Kvasnovsky CL reviewed and edited the manuscript.
Supported by National Institute on Aging of the National Institute of Health, No. R24AG06419; National Library of Medicine of the National Institutes of Health, No. R01LM012836.
Institutional review board statement: This study protocol was approved by the Northwell Health Institutional Review Board.
Informed consent statement: Informed consent statement was waived.
Conflict-of-interest statement: The authors declare no conflicts of interest related to the content of the manuscript.
Data sharing statement: The data that support the findings of this study are available on request from COVID19@northwell.edu. The data are not publicly available due to restrictions as it could compromise the privacy of research participants.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: David Bernstein, FAASLD, MACG, MD, Professor, Department of Medicine/Hepatology, Northwell Health, Zucker School of Medicine at Hofstra/Northwell, 400 Community Drive, Manhasset, NY 11030, United States. dbernste@northwell.edu
Received: January 30, 2021
Peer-review started: January 30, 2021
First decision: June 4, 2021
Revised: July 12, 2021
Accepted: October 24, 2021
Article in press: October 24, 2021
Published online: November 14, 2021
ARTICLE HIGHLIGHTS
Research background

Liver enzyme abnormalities are commonly seen in coronavirus disease 2019 (COVID-19) infection. We assessed the prevalence and prognostic value of the initial liver enzymes in patients admitted to hospital with COVID-10 infection.

Research motivation

At the time of the writing of this manuscript, our health system had data on 10614 individual patients admitted with COVID-10 infection. We wanted to assess the prevalence of liver enzyme abnormalities in these patients and determine if any particular enzyme pattern would predict prognosis.

Research objectives

Determine the prevalence of abnormal liver enzymes in patients admitted to the hospital with COVID-19 infection. Determine the prognostic value of initial liver enzymes on mortality and/or the need for mechanical ventilation. Determine if any particular abnormal liver enzyme pattern was most predictive of poor outcome in COVID-19 infection.

Research methods

Review of electronic medical records of 10614 patients admitted to the hospital with COVID-19 infection.

Research results

Elevated liver enzymes are common upon initial hospital presentation of COVID-19 infection.

Research conclusions

Increased mortality and the need for mechanical ventilation is associated with elevated hepatic enzymes in COVID-19 patients without chronic liver disease.

Research perspectives

This is an important study which highlights the importance of initial liver enzyme patterns in predicting outcomes. Health care workers should be aware of these findings to better triage COVID-19 patients.