Risk Factors and Prognosis in Patients with COVID-19 and Liver Injury: A Retrospective Analysis
Authors Shen JX, Zhuang ZH, Zhang QX, Huang JF, Chen GP, Fang YY, Cheng AG
Received 22 November 2020
Accepted for publication 15 January 2021
Published 10 March 2021 Volume 2021:14 Pages 629—637
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Scott Fraser
Jia-Xin Shen,1 Ze-Hao Zhuang,1 Qiao-Xian Zhang,2 Jiao-Feng Huang,3 Gong-Ping Chen,4 Ying-Ying Fang,5 Ai-Guo Cheng6
1Endoscopy Center, First Affiliated Hospital of Fujian Medical University, Fuzhou, People’s Republic of China; 2Nursing Department, First Affiliated Hospital of Fujian Medical University, Fuzhou, People’s Republic of China; 3Department of Liver Research Center, First Affiliated Hospital of Fujian Medical University, Fuzhou, People’s Republic of China; 4Department of Pulmonary and Critical Care Medicine, First Affiliated Hospital of Fujian Medical University, Fuzhou, People’s Republic of China; 5Department of Tuberculosis, Third People’s Hospital of Yichang, Yichang, People’s Republic of China; 6Department of Critical Care, Third People’s Hospital of Yichang, Yichang, People’s Republic of China
Correspondence: Ze-Hao Zhuang
Endoscopy Center, First Affiliated Hospital of Fujian Medical University, 20, Chazhong Road, Taijiang District, Fuzhou, 350005, Fujian Province, People’s Republic of China
Email [email protected]
Purpose: COVID-19 is a new infectious disease with global spread. The aim of the present study was to explore possible risk factors and evaluate prognosis in COVID-19 with liver injury.
Methods: A retrospective study was conducted on 356 COVID-19 patients in the Third People’s Hospital of Yichang, Hubei, China. Clinical characteristics and laboratory tests between patients with and without liver injury were compared, while risk factors of COVID-19–related liver injury were analyzed. Univariate and multivariate Cox regression analyses were conducted to identify risk factors of in-hospital death.
Results: Of the patients with liver injury, severe and critical types of COVID-19 comprised 12.43% and 14.69%, respectively, higher than in patients without liver injury (both P< 0.05). CRP and male sex were independent risk factors for for patients with liver injury, while decreased lymphocyte count (HR 0.024, 95% CI 0.001– 0.821) and elevated monocytes (HR 1.951, 95% CI 1.040– 3.662) and CRP (HR 1.028, 95% CI 1.010– 1.045) were independent risk factors of prognosis of death in COVID-19 patients with liver injury.
Conclusion: Liver injury is a common complication in severe COVID-19 patients. Male sex and elevated CRP were independent risk factors in COVID-19 complicated by liver damage. Liver damage with increased CRP and monocyte count and decreased lymphocyte count may imply a poor prognosis.
Keywords: COVID-19, liver injury, risk factors, prognosis
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