|
1
|
Ghoreshi ZAS, Abbasi-Jorjandi M, Asadikaram G, Sharif-Zak M, Haddad MK, Afgar A, Arefinia N, Dabiri S, Rosen C. Time Course of Biochemical and Metabolic Parameters During and After COVID-19. Curr Med Chem 2025; 32:1803-1816. [PMID: 38284721 DOI: 10.2174/0109298673282210231220115719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 11/27/2023] [Accepted: 11/29/2023] [Indexed: 01/30/2024]
Abstract
BACKGROUND Long COVID is characterized by the persistence of symptoms among individuals who are infected with the SARS-CoV-2 virus. The enduring impact of these long-term effects on the health and well-being of those affected cannot be denied. METHODS 470 patients with SARS-CoV-2 were consecutively recruited in this longitudinal study. The participants were entered into moderate, severe, and critical groups. 235 out of 470 participants were female. The levels of fasting blood sugar (FBS), alanine transaminase (SGPT), aspartate aminotransferase (SGOT), alkaline phosphatase (ALP), creatinine (Cr), urea, uric acid (UA), and total protein (TP) were measured during hospitalization and again at one and three months after infection. The levels of Zn and hemoglobin A1c (HbA1c) were also measured only during hospitalization. RESULTS COVID-19 severity was associated with high levels of glucose, urea, Cr, ALT, AST, ALP, and HbA1c, and low levels of Zn, UA, and TP. There were significant sex differences for these markers at all three-time points. Glucose, urea, Cr, ALT, AST, and ALP all decreased three months after infection, whereas the levels of UA and TP returned towards normal. CONCLUSION COVID-19 infection affects the levels of multiple biochemical factors in a gender-dependent manner. The biochemical changes become more tangible with increasing disease severity, and several of these predict mortality. Levels begin to return to normal after the acute phase of the disease, but in some individuals, at three months, several markers were still not within the normal range. Whether the trajectory of these changes can predict long COVID requires further testing.
Collapse
Affiliation(s)
- Zohreh-Al-Sadat Ghoreshi
- Research Center of Tropical and Infectious Diseases, Kerman University of Medical Sciences, Kerman, Iran
- Department of Biochemistry, School of Medicine, Jiroft University of Medical Sciences, Jiroft, Iran
- Department of Biochemistry, Applied Cellular and Molecular Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Mojtaba Abbasi-Jorjandi
- Department of Biochemistry, Applied Cellular and Molecular Research Center, Kerman University of Medical Sciences, Kerman, Iran
- Department of Clinical Biochemistry, Afzalipour Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Gholamreza Asadikaram
- Department of Biochemistry, Applied Cellular and Molecular Research Center, Kerman University of Medical Sciences, Kerman, Iran
- Department of Clinical Biochemistry, Afzalipour Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohsen Sharif-Zak
- Department of Clinical Biochemistry, Afzalipour Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Khaksari Haddad
- Physiology Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Ali Afgar
- Department of Parasitology and Mycology, Afzalipour Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Nasir Arefinia
- Department of Biochemistry, School of Medicine, Jiroft University of Medical Sciences, Jiroft, Iran
| | - Shahriar Dabiri
- Department of Pathology, Afzalipour Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Clifford Rosen
- Department of MaineHealth, MaineHealth Institue for Research, Scarborough, Maine, 04074, USA
| |
Collapse
|
|
2
|
Himral P, Bhawani R, Bhardwaj M, Sharma N. Liver function tests at admission as marker of severity and prognosis in COVID-19 patients - A retrospective analysis. J Family Med Prim Care 2023; 12:3108-3114. [PMID: 38361891 PMCID: PMC10866267 DOI: 10.4103/jfmpc.jfmpc_2407_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 05/17/2023] [Accepted: 05/23/2023] [Indexed: 02/17/2024] Open
Abstract
Introduction With evolving pandemic, a substantial proportion of patients are presenting with liver dysfunction as an extra-pulmonary manifestation of COVID-19 illness. We planned this study to evaluate the incidence of liver dysfunction in COVID-19 pneumonia and find an association between abnormal liver function and the severity of the disease. Method We retrospectively analysed the hospital records of 344 patients with moderate to severe COVID-19 illness admitted to a Dedicated COVID Hospital in North India. Results Out of 344 patients included in the study, 59.9% were males. The abnormal liver functions were present in 78.49% of patients at admission. Mean age of the patient with liver dysfunction was 53.41 ± 15.71 years. The incidence of elevated aspartate aminotransferase (AST), alanine aminotransferase (ALT), and hypoalbuminemia was 82.96%, 74.91%, and 69.7%, respectively, in patients with COVID-19 at admission. A positive correlation was found between the levels of AST, ALT and hypoalbuminemia with severity of disease. Mortality was 33% in patients with liver dysfunction in comparison to 18.9% in patients with normal liver functions. Conclusion More than 75% of the patient had abnormal liver functions at admission, and mortality was also high in this group. Mortality can be effectively reduced if laboratory parameters such as elevated AST and ALT and hypoalbuminemia are closely monitored at admission and during hospital stay in patients with risk factors like male, age <55 years and HTN.
Collapse
Affiliation(s)
- Pratibha Himral
- Department of General Medicine, Shri Lal Bahadur Shastri Government Medical College and Hospital Mandi at Ner Chowk, District Mandi Himachal Pradesh, India
| | - Rajesh Bhawani
- Department of General Medicine, Shri Lal Bahadur Shastri Government Medical College and Hospital Mandi at Ner Chowk, District Mandi Himachal Pradesh, India
| | - Manisha Bhardwaj
- Department of Pulmonary Medicine, Shri Lal Bahadur Shastri Government Medical College and Hospital Mandi at Ner Chowk, District Mandi Himachal Pradesh, India
| | - Nikhil Sharma
- Department of General Medicine, Shri Lal Bahadur Shastri Government Medical College and Hospital Mandi at Ner Chowk, District Mandi Himachal Pradesh, India
| |
Collapse
|
|
3
|
Almadhidi J, Ali Mohammed A, Hadi Jasim H. The study of some biochemical parameters in the serum of infected and recovered patients with COVID-19. BIONATURA 2023; 8:1-8. [DOI: 10.21931/rb/css/s2023.08.01.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2025] Open
Abstract
Few biochemical and immunological studies have been conducted on Iraqis infected with novel coronaviruses, and also Patients' post-recovery condition is
unknown. Therefore, we aimed to study the impact of COVID-19 on some biochemical compounds in the serum of the infected subjects and to follow up the
impact after 6-7 months. The research was conducted in Baghdad-Iraq from October to December 2021, and the study included four groups (each group consisted
of 20 subjects): Group (A) Infected subjects without vaccination; group (B) Recovered subjects without vaccination; group (C) Recovered subjects after vaccination; and group (D) Non-infected subjects after vaccination. Subjects with
COVID-19 infection confirmed by PCR and vaccinated individuals received the
same type of vaccine. The authors measured some positive acute phase reactants
(ferritin, C-reactive protein, and D-dimer), antibodies (IgM and IgG), and enzymes (LDH, AST, and ALT) in the subjects' serum. The study result showed an
Increase in ferritin, CRP, D-dimer and LDH levels in the serum of infected subjects (group A). The antibody levels in the four groups were elevated, while the
liver enzymes (ALT and AST) were in the normal values. Elevation of LDH level
also in the serum of recovered subjects (groups B and C). Elevated ferritin, CRP,
and D-dimer levels may not remain in infected patients after recovery from
COVID-19 except for LDH, which is still elevated in some Iraqi subjects in
Baghdad.
Keywords: Iraq, COVID-19, Vaccine, Acute Phase Reactants, Antibodies,
Liver enzymes
Collapse
Affiliation(s)
- Jamal Almadhidi
- Department of Chemistry and Biochemistry, Faculty of Medicine, Fallujah University, Iraq
| | - Abdullah Ali Mohammed
- Department of Chemistry and Biochemistry, Faculty of Medicine, Fallujah University, Iraq
| | - Husam Hadi Jasim
- Department of Chemistry and Biochemistry, Faculty of Medicine, Fallujah University, Iraq
| |
Collapse
|
|
4
|
Röckert Tjernberg A, Malmborg P, Mårild K. Coronavirus disease 2019 and gastrointestinal disorders in children. Therap Adv Gastroenterol 2023; 16:17562848231177612. [PMID: 37305380 PMCID: PMC10243097 DOI: 10.1177/17562848231177612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 05/06/2023] [Indexed: 06/13/2023] Open
Abstract
During the past 3 years, the coronavirus disease 2019 (COVID-19) pandemic has had a great impact on people all over the world. However, it has become evident that disease manifestations and severity differ across age groups. Most children have a milder disease course than adults but possibly more pronounced gastrointestinal (GI) symptoms. Given the child's developing immune system, the impact of COVID-19 on disease development may differ compared to adults. This study reviews the potential bi-directional relationship between COVID-19 and GI diseases in children, focusing on common pediatric conditions such as functional GI disorders (FGID), celiac disease (CeD), and inflammatory bowel disease (IBD). Children with GI diseases, in general, and CeD and IBD, in particular, do not seem to have an increased risk of severe COVID-19, including risks of hospitalization, critical care need, and death. While infections are considered candidate environmental factors in both CeD and IBD pathogenesis, and specific infectious agents are known triggers for FGID, there is still not sufficient evidence to implicate COVID-19 in the development of either of these diseases. However, given the scarcity of data and the possible latency period between environmental triggers and disease development, future investigations in this field are warranted.
Collapse
Affiliation(s)
- Anna Röckert Tjernberg
- Department of Pediatrics, Kalmar County Hospital, Region Kalmar County, Kalmar S-391 85, Sweden
| | - Petter Malmborg
- Sachs’ Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
- Department of Medicine Solna, Division of Clinical Epidemiology, Karolinska Institutet, Stockholm, Sweden
| | - Karl Mårild
- Department of Pediatrics, Queen Silvia Children’s Hospital, Gothenburg, Sweden
- Department of Pediatrics, Institute of Clinical Science, University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
|
5
|
Wongtanasarasin W. Cholestatic liver injury: A rare but fatal complication during and after COVID-19 infection. World J Virol 2022; 11:435-442. [PMID: 36483106 PMCID: PMC9724201 DOI: 10.5501/wjv.v11.i6.435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 09/21/2022] [Accepted: 10/19/2022] [Indexed: 11/23/2022] Open
Abstract
The 2019 coronavirus disease (COVID-19), resulting from the severe acute respiratory syndrome 2 virus, has transformed our globe and provided a new perspective on respiratory tract infections. However, COVID-19 would not be recognized as a condition restricted to only pneumonia. This narrative review was conducted by searching manuscripts in several databases, including PubMed/ MEDLINE, Web of Science, and Reference Citation Analysis, from December 2019 to July 2022. Many studies have revealed a broad spectrum of potential systemic symptoms, including biliary complications. Although biliary injury has been observed in a very low proportion of COVID-19 patients, it is associated with increased mortalities and long-term morbidities. We identify a cholangiopathy condition in individuals during infection and after recovering from severe COVID-19, defined by a significant increase in serum alkaline phosphatase and signs of bile duct injury. Understanding the pathogeneses behind this condition would help us develop new techniques to prevent these complications. This review thoroughly discusses and summarizes the current information regarding COVID-19-associated cholangiopathy. In addition, the possible explanations for COVID-19-associated cholangiopathy are presented. Since the exact pathogenesis may not be concluded, this review could provide relevant information to encourage additional investigations shortly.
Collapse
Affiliation(s)
- Wachira Wongtanasarasin
- Department of Emergency Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
- Department of Emergency Medicine, UC Davis School of Medicine, Sacramento, CA 95817, United States
| |
Collapse
|
|
6
|
Cooper KM, Colletta A, Asirwatham AM, Moore Simas TA, Devuni D. COVID-19 associated liver injury: A general review with special consideration of pregnancy and obstetric outcomes. World J Gastroenterol 2022; 28:6017-6033. [PMID: 36405386 PMCID: PMC9669825 DOI: 10.3748/wjg.v28.i42.6017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 10/24/2022] [Accepted: 10/27/2022] [Indexed: 11/15/2022] Open
Abstract
Liver injury is an increasingly recognized extra-pulmonary manifestation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Coronavirus disease 2019 (COVID-19) associated liver injury (COVALI) is a clinical syndrome encompassing all patients with biochemical liver injury identified in the setting of SARS-CoV-2 infection. Despite profound clinical implications, its pathophysiology is poorly understood. Unfortunately, most information on COVALI is derived from the general population and may not be applicable to individuals under-represented in research, including pregnant individuals. This manuscript reviews: Clinical features of COVALI, leading theories of COVALI, and existing literature on COVALI during pregnancy, a topic not widely explored in the literature. Ultimately, we synthesized data from the general and perinatal populations that demonstrates COVALI to be a hepatocellular transaminitis that is likely induced by systemic inflammation and that is strongly associated with disease severity and poorer clinical outcome, and offered perspective on approaching transaminitis in the potentially COVID-19 positive patient in the obstetric setting.
Collapse
Affiliation(s)
- Katherine M. Cooper
- Department of Medicine, University of Massachusetts Chan Medical School, Worcester, MA 01605, United States
| | - Alessandro Colletta
- Department of Medicine, University of Massachusetts Chan Medical School, Worcester, MA 01605, United States
| | - Alison M. Asirwatham
- Department of Obstetrics and Gynecology, University of Massachusetts Chan Medical School, Worcester, MA 01605, United States
| | - Tiffany A. Moore Simas
- Department of Obstetrics and Gynecology, University of Massachusetts Chan Medical School, Worcester, MA 01605, United States
- Departments of Pediatrics, Psychiatry, and Population & Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA 01605, United States
| | - Deepika Devuni
- Department of Medicine, University of Massachusetts Chan Medical School, Worcester, MA 01605, United States
- Division of Gastroenterology and Hepatology, University of Massachusetts Chan Medical School, Worcester, MA 1605, United States
| |
Collapse
|
|
7
|
Al-Shammari AH, Ali Shahadha MA. The effect of Favipiravir on liver enzyme among patients with mild to moderate COVID-19 infection: A prospective cohort study. JOURNAL OF POPULATION THERAPEUTICS AND CLINICAL PHARMACOLOGY = JOURNAL DE LA THERAPEUTIQUE DES POPULATIONS ET DE LA PHARMACOLOGIE CLINIQUE 2022; 29:e46-e54. [PMID: 36398597 DOI: 10.15586/jptcp.2022.967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 10/11/2022] [Indexed: 06/16/2023]
Abstract
Teratogenicity and hyperuricemia are considered as the major adverse effects of favipiravir, but less is known about other possible side effects which includes drug-induced liver damage and renal injury. In the current research, assessment of favipiravir-induced liver injury was performed by evaluating liver enzymes among patients with mild to moderate COVID-19 infection. A prospective cohort study was conducted on 66 patients diagnosed with mild to moderate COVID-19 infection who were treated with favipiravir for 5 days. During this period, a baseline assessment of liver enzymes (aspartate aminotransferase - AST, alanine transaminase - ALT and alkaline phosphatase - ALP) in addition to bilirubin before initiation of therapy and after 1 day of completion of therapy were carried out. The comparison of all measured parameters among all patients before and after receiving the treatment showed that non-significant differences were obtained in their levels. It was noticed that COVID-19 patients demonstrated high AST levels in which only 16 patients out of the all-subjected cases (66 patients) had AST levels of less than 45 U/L whereas the majority of patients showed normal ALT, ALP, and bilirubin levels. It was concluded that 5 days administration of favipiravir in mild to moderate COVID-19 patients who had no previous liver diseases did not affect the liver enzymes significantly and only transient elevations were occurred.
Collapse
|
|
8
|
Developing a Simple Score for Diagnosis of Acute Cholecystitis at the Emergency Department. Diagnostics (Basel) 2022; 12:diagnostics12092246. [PMID: 36140646 PMCID: PMC9497808 DOI: 10.3390/diagnostics12092246] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 09/11/2022] [Accepted: 09/16/2022] [Indexed: 12/07/2022] Open
Abstract
We aim to develop a diagnostic score for acute cholecystitis that integrates symptoms, physical examinations, and laboratory data to help clinicians for timely detection and early treatment of this disease. We retrospectively collected data from our database from 2010 to 2020. Patients with acute abdominal pain who underwent an ultrasound or computed tomography (CT) scan at the emergency department (ED) were included. Cases were identified by pathological, CT, or ultrasound reports. Non-cases were those who did not fulfill any of these criteria. Multivariable regression analysis was conducted to identify predictors of acute cholecystitis. The model included 244 patients suspected of acute cholecystitis. Eighty-six patients (35.2%) were acute cholecystitis confirmed cases. Five final predictors remained within the reduced logistic model: age < 60, nausea and/or vomiting, right upper quadrant pain, positive Murphy’s sign, and AST ≥ two times upper limit of normal. A practical score diagnostic performance was AuROC 0.74 (95% CI, 0.67−0.81). Patients were categorized with a high probability of acute cholecystitis at score points of 9−12 with a positive likelihood ratio of 3.79 (95% CI, 1.68−8.94). ED Chole Score from these five predictors may aid in diagnosing acute cholecystitis at ED. Patients with an ED Chole Score >8 should be further investigated.
Collapse
|
|
9
|
Alavian SE, Mofidi M, Shahabipour F. Effect of COVID-19 on Serum Activity of Liver Enzymes: Is This Associated with Severity and Mortality Rate? IBNOSINA JOURNAL OF MEDICINE AND BIOMEDICAL SCIENCES 2022. [DOI: 10.1055/s-0042-1759739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Abstract
Introduction Coronavirus disease 2019 (COVID-19) is a viral infection caused by a novel coronavirus known as the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The disease raises an enormous public health challenge for the international community. Liver enzymes have been reported to be frequently elevated in hospitalized patients with severe COVID-19 disease.
Materials and Methods This article is a narrative review of abnormal liver tests and liver injury as a manifestation of progression to severe pneumonia. We collected data from the PubMed database (National Library of Medicine, Bethesda, Maryland, United States). We used the search term “abnormal liver test” and relevant records were measured. The review article was organized thematically.
Results This narrative review aims to summarize the available clinical data on abnormal liver enzymes in coronavirus infection and its association with the risk of mortality, severer pneumonia, and systemic inflammation. Some clinical studies refer to abnormal liver tests and liver injury as a manifestation of progression to severe pneumonia. Recent research verified the relationship between hepatic liver enzyme activities and liver damage in patients with COVID-19, which suggested that it might reflect the infection severity and the mortality risk. Thus, this review investigated the correlation between liver serum enzymes level and the severity of COVID-19 patients, by reviewing investigating the relationship between the illness severity in COVID-19 patients with abnormal liver tests, liver pathology, and markers of inflammation.
Conclusion In the current pandemic of SARS-CoV-2, abnormalities of liver enzyme tests were commonly observed in patients with COVID-19. However, because of multiorgan damages that observed in COVID-19 patients, various issues should be considered such as the pathology and pathophysiology of the liver tissue, especially on the activation process of the immune response and cytokine storm to prevent the severity of the disease.
Collapse
Affiliation(s)
- Seyed Ehsan Alavian
- Middle East Liver Disease (MELD) Virology Laboratory, MELD Center, Tehran, Iran
| | - Mohammad Mofidi
- Department of Laboratory Science, Faculty of Paramedical, Golestan University of Medical Science, Gorgan, Iran
| | - Fahimeh Shahabipour
- Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Skin Research Center, Shahid Beheshti of Medical Science, Tehran, Iran
| |
Collapse
|
|
10
|
Madikyzy M, Tilegen M, Nazarbek G, Mu C, Kutzhanova A, Li X, Ma C, Xie Y. Honghua extract mediated potent inhibition of COVID-19 host cell pathways. Sci Rep 2022; 12:14296. [PMID: 35995784 PMCID: PMC9395372 DOI: 10.1038/s41598-022-15338-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 06/22/2022] [Indexed: 11/08/2022] Open
Abstract
Honghua (Carthami flos) and Xihonghua (Croci stigma) have been used in anti-COVID-19 as Traditional Chinese Medicine, but the mechanism is unclear. In this study, we applied network pharmacology by analysis of active compounds and compound-targets networks, enzyme kinetics assay, signaling pathway analysis and investigated the potential mechanisms of anti-COVID-19. We found that both herbs act on signaling including kinases, response to inflammation and virus. Moreover, crocin likely has an antiviral effect due to its high affinity towards the human ACE2 receptor by simulation. The extract of Honghua and Xihonghua exhibited nanozyme/herbzyme activity of alkaline phosphatase, with distinct fluorescence. Thus, our data suggest the great potential of Honghua in the development of anti-COVID-19 agents.
Collapse
Affiliation(s)
- Malika Madikyzy
- Department of Biology, School of Sciences and Humanities, Nazarbayev University, 53 Kabanbay Batyr Ave, 010000, Nur-Sultan, Republic of Kazakhstan
| | - Meruyert Tilegen
- Department of Biology, School of Sciences and Humanities, Nazarbayev University, 53 Kabanbay Batyr Ave, 010000, Nur-Sultan, Republic of Kazakhstan
| | - Guldan Nazarbek
- Department of Biology, School of Sciences and Humanities, Nazarbayev University, 53 Kabanbay Batyr Ave, 010000, Nur-Sultan, Republic of Kazakhstan
| | - Chenglin Mu
- Sino-German Joint Research Center on Agricultural Biology, State Key Laboratory of Crop Biology, College of Life Sciences, Shandong Agricultural University, Tai'an, 271018, China
- Zhejiang University-Hangzhou Global Scientific and Technological Innovation Center, Hangzhou, China
| | - Aidana Kutzhanova
- Department of Biology, School of Sciences and Humanities, Nazarbayev University, 53 Kabanbay Batyr Ave, 010000, Nur-Sultan, Republic of Kazakhstan
| | - Xugang Li
- Sino-German Joint Research Center on Agricultural Biology, State Key Laboratory of Crop Biology, College of Life Sciences, Shandong Agricultural University, Tai'an, 271018, China
| | - Cuiping Ma
- Shandong Provincial Key Laboratory of Biochemical Engineering, Qingdao Nucleic Acid Rapid Detection Engineering Research Center, College of Marine Science and Biological Engineering, Qingdao University of Science and Technology, Qingdao, 266042, China
| | - Yingqiu Xie
- Department of Biology, School of Sciences and Humanities, Nazarbayev University, 53 Kabanbay Batyr Ave, 010000, Nur-Sultan, Republic of Kazakhstan.
| |
Collapse
|
|
11
|
Tokarczyk U, Kaliszewski K, Kopszak A, Nowak Ł, Sutkowska-Stępień K, Sroczyński M, Sępek M, Dudek A, Diakowska D, Trocha M, Gajecki D, Gawryś J, Matys T, Maciejiczek J, Kozub V, Szalast R, Madziarski M, Zubkiewicz-Zarębska A, Letachowicz K, Kiliś-Pstrusińska K, Matera-Witkiewicz A, Pomorski M, Protasiewicz M, Sokołowski J, Adamik B, Kujawa K, Doroszko A, Madziarska K, Jankowska EA. Liver Function Tests in COVID-19: Assessment of the Actual Prognostic Value. J Clin Med 2022; 11:jcm11154490. [PMID: 35956107 PMCID: PMC9369475 DOI: 10.3390/jcm11154490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 07/28/2022] [Accepted: 07/29/2022] [Indexed: 01/08/2023] Open
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 < 0.001). Additionally, we determined that hypoalbuminemia in combination with AST (OR 1.003, 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.
Collapse
Affiliation(s)
- Urszula Tokarczyk
- Clinical Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland; (K.S.-S.); (M.S.); (M.S.); (A.D.)
- Correspondence: (U.T.); (K.K.); Tel.: +48-723-781-491 (U.T.); +48-71-734-30-00 (K.K.); Fax: +48-71-734-30-00 (K.K.)
| | - Krzysztof Kaliszewski
- Clinical Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland; (K.S.-S.); (M.S.); (M.S.); (A.D.)
- Correspondence: (U.T.); (K.K.); Tel.: +48-723-781-491 (U.T.); +48-71-734-30-00 (K.K.); Fax: +48-71-734-30-00 (K.K.)
| | - Anna Kopszak
- Statistical Analysis Center, Wroclaw Medical University, Marcinkowski Street 2-6, 50-368 Wroclaw, Poland; (A.K.); (K.K.)
| | - 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; (K.S.-S.); (M.S.); (M.S.); (A.D.)
| | - Maciej Sroczyński
- Clinical Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland; (K.S.-S.); (M.S.); (M.S.); (A.D.)
| | - Monika Sępek
- Clinical Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland; (K.S.-S.); (M.S.); (M.S.); (A.D.)
| | - Agata Dudek
- Clinical Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland; (K.S.-S.); (M.S.); (M.S.); (A.D.)
| | - 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; (D.G.); (J.G.); (T.M.); (A.D.)
| | - Jakub Gawryś
- Clinical Department of Internal and Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland; (D.G.); (J.G.); (T.M.); (A.D.)
| | - Tomasz Matys
- Clinical Department of Internal and Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland; (D.G.); (J.G.); (T.M.); (A.D.)
| | - Justyna Maciejiczek
- Clinical Department of Internal Medicine, Pneumology and Allergology, Wroclaw Medical University, M. Skłodowskiej-Curie Street 66, 50-369 Wroclaw, Poland; (J.M.); (V.K.); (R.S.)
| | - Valeriia Kozub
- Clinical Department of Internal Medicine, Pneumology and Allergology, Wroclaw Medical University, M. Skłodowskiej-Curie Street 66, 50-369 Wroclaw, Poland; (J.M.); (V.K.); (R.S.)
| | - Roman Szalast
- Clinical Department of Internal Medicine, Pneumology and Allergology, Wroclaw Medical University, M. Skłodowskiej-Curie Street 66, 50-369 Wroclaw, Poland; (J.M.); (V.K.); (R.S.)
| | - 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; (K.L.); (K.M.)
| | - 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; (A.K.); (K.K.)
| | - Adrian Doroszko
- Clinical Department of Internal and Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland; (D.G.); (J.G.); (T.M.); (A.D.)
| | - Katarzyna Madziarska
- Clinical Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland; (K.L.); (K.M.)
| | - Ewa Anita Jankowska
- University Hospital in Wroclaw, Institute of Heart Diseases, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland;
| |
Collapse
|
|
12
|
Roy S, Kumar R, Jana P, Priyadarshini I, Datta P, Das S. An evaluation of liver function tests in severe acute respiratory syndrome - Corona virus 2 (SARS-CoV-2) infection in the backdrop of chronic kidney disease. J Family Med Prim Care 2022; 11:751-757. [PMID: 35360812 PMCID: PMC8963642 DOI: 10.4103/jfmpc.jfmpc_1594_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 12/14/2021] [Accepted: 12/17/2021] [Indexed: 11/26/2022] Open
Abstract
Background: The SARS-CoV-2 pandemic has emerged as the most challenging global health problem of this century. The concomitant presence of co-morbidities like chronic kidney disease (CKD), diabetes, CHD, further complicates the problem. Aim: To assess the patterns of LFT abnormalities in patients of SARS-CoV-2 infection with and without CKD and evaluate the probable outcomes. Materials and Methods: A cross-sectional retrospective observational study done on 600 patient samples (Group 1: SARS-CoV-2 without CKD, Group 2: SARS-CoV-2 with CKD and Group 3: CKD uninfected with SARS-CoV-2) which were processed for LFT and KFT. Results: AST and ALT were significantly higher in all SARS-CoV-2 infected; Group 1 mean ± 2SD, (63.63 ± 42.89U/L & 50.25 ± 46.53U/L), group 2 (90.59 ± 62.51U/L & 72.09 ± 67.24 U/L) as compared to Group 3 (25.24 ± 7.47U/L & 24.93 ± 11.44U/L). A statistically significant elevation is seen in these two parameters in Group 2 as compared to Group 1. There was a negative significant correlation between eGFR and AST/ALT levels in Group 1 (p < 0.05). In Group 2, a weak positive correlation was seen with ALT. Group 3, eGFR’s showed strong correlations with AST and ALT levels; reduction in kidney function correlated well with increase in serum ALP levels. Conclusions: This study establishes that SARS-CoV-2 infected, with CKD, show higher elevations in serum aminotransferase levels in comparison to those without CKD. In contrast, the CKD group not infected, shows a decline in serum aminotransferase levels. Serum ALT values in SARS-CoV-2 show significant correlation with eGFR. Also, elevated ALP values in CKD patients may be used as an indicator of declining kidney function.
Collapse
|
|
13
|
Hwaiz RA, Zaki Abdullah SM, Jalal Balaky ST, Ali KS, Merza MY, Khailani SA, Shabila NP. Clinical and hematological characteristics of 300 COVID-19 patients in Erbil, Kurdistan Region, Iraq. Int J Immunopathol Pharmacol 2022; 36:3946320221085465. [PMID: 35341332 PMCID: PMC8958335 DOI: 10.1177/03946320221085465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Background COVID-19 primarily presents as a respiratory tract infection, but studies
indicate that it could be considered a systemic disease that can spread to
affect multiple organ systems, including respiratory, cardiovascular,
gastrointestinal, hematopoietic, neurological, and immune systems. Objective To describe and analyze the clinical and hematological characteristics of 300
hospitalized COVID-19 patients in Erbil, Kurdistan. Methods This retrospective study included 300 patients of any age admitted to
hospital due to confirmed COVID-19 between September 2020 and February 2021.
Cases were diagnosed by reverse transcriptase polymerase chain reaction
assays of nasopharyngeal swab specimens. Results The highest proportion of patients were aged 21–40 years. The most common
symptoms among the patients were myalgia (66.7%), fatigue (62.3%), headache
(50.7%), and chest pain (52.7%). Differences in hematological and
biochemical parameters were observed between deceased and recovered
patients. Only the mid-range absolute count percentage (MID%) was
significantly higher in the recovered patients than in the deceased ones
(6.41% vs. 4.48, p = 0.019). Death was significantly higher
among older patients (>40 years) than younger ones (≤40 years) (6.8% vs.
1.3%, p = 0.015), diabetic than non-diabetic (10.8% vs. 3%,
p = 0.047), and those having chronic diseases than
those without chronic diseases (10.6% vs. 2.1%, p =
0.006). Conclusions Different hematological and biochemical parameter findings were observed
among the COVID-19 patients. Low MID%, older age, and presence of diabetes
mellitus and chronic disease were significantly associated with death among
COVID-19 patients.
Collapse
Affiliation(s)
- Rundk Ahmad Hwaiz
- Department of Clinical Biochemistry, College of Health Sciences, 125618Hawler Medical University, Erbil, Iraq.,Medical Analysis Department, 605021Tishk International University, Erbil, Iraq
| | | | - Salah Tofik Jalal Balaky
- Medical Analysis Department, 605021Tishk International University, Erbil, Iraq.,Department of Medical Microbiology, College of Health Sciences, 125618Hawler Medical University, Erbil, Iraq
| | - Katan Sabir Ali
- Department of Medical Microbiology, College of Health Sciences, 125618Hawler Medical University, Erbil, Iraq
| | - Mohammed Yousif Merza
- Medical Analysis Department, 605021Tishk International University, Erbil, Iraq.,Department of Clinical Analysis, College of Pharmacy, 125618Hawler Medical University, Erbil, Iraq.,Medical Biochemical Analysis Department, College of Health Technology, Cihan University, Erbil, Iraq
| | | | - Nazar Pauls Shabila
- Department of Community Medicine, College of Medicine, 125618Hawler Medical University, Erbil, Iraq
| |
Collapse
|