Liver Injury Linked With Worse COVID-19 Outcomes

By Reuters Staff

July 29, 2020

NEW YORK (Reuters Health) - Liver injury is associated with an increased risk of developing severe COVID-19 and dying of the disease, according to a systematic review and meta-analysis.

Most studies have reported abnormal liver function in association with COVID-19, but it remains unclear whether those abnormalities contribute to outcomes.

Dr. Tingbo Liang of Zhejiang University School of Medicine First Affiliated Hospital, in Hangzhou, China, and colleagues used data from nine studies including a total of 2,115 patients to estimate the prognosis of COVID-19 stratified according to liver injury.

In those studies, 37.2% to 76.3% of patients had abnormal liver function, and the prevalence of liver injury ranged from 21.5% to 45.7% of COVID-19 patients, the researchers note in Gut.

The overall incidence of liver injury was 27% and was higher in older patients with COVID-19.

Patients with liver injury had significantly lower absolute lymphocyte counts and higher erythrocyte sedimentation rates (ESR) than did patients without liver injury, but there was no remarkable difference between the groups in C-reactive protein (CRP) or absolute neutrophil count.

The odds of receiving treatment with lopinavir/ritonavir were 4.15 times greater among patients with liver injury than among those without (P<0.00001).

Patients with liver injury had 2.57 times higher odds of developing severe COVID-19 (P=0.01) and 66% greater odds of mortality (P=0.03), but the length of hospital stay did not differ significantly between the groups.

Overall, 53.5% of patients with liver injury had severe COVID-19 and 23.5% of patients with liver injury died.

"Thus," the authors conclude, "special attention should be given to any liver dysfunction while treating patients with COVID-19."

Dr. Liang did not respond to a request for comments.

SOURCE: Gut, online July 15, 2020.