KCI등재
SCOPUS
Changing Features of Liver Injury in COVID-19 Patients: Impact of Infection with the SARS-CoV-2 Delta (B.1.617.2) Variants
저자
Choi Chang Wan (Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Medical Center, Seoul, Korea.) ; Sung Ho Kyung (National Emergency Medical Center, National Medical Center, Seoul, Korea.Research Institute for Public Health, National Medical Center, Seoul, Korea.) ; Jeong Jae Yoon (Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Medical Center, Seoul, Korea.) ; Lim Dae Hyun (Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Medical Center, Seoul, Korea.) ; Choi Jongkyoung (Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Medical Center, Seoul, Korea.) ; Kwon Hyeok Choon (Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Medical Center, Seoul, Korea.) ; Nam Seongwoo (Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Medical Center, Seoul, Korea.) ; Kim Yeonjae (Division of Infectious Diseases, Department of Internal Medicine, National Medical Center, Seoul, Korea.) ; Chin Bum Sik (Division of Infectious Diseases, Department of Internal Medicine, National Medical Center, Seoul, Korea.) 연구자관계분석
발행기관
학술지명
권호사항
발행연도
2022
작성언어
English
주제어
등재정보
KCI등재,SCOPUS,ESCI
자료형태
학술저널
수록면
744-756(13쪽)
DOI식별코드
제공처
Background There is growing evidence that abnormal liver function tests (LFTs) are common in patients with coronavirus disease 2019 (COVID-19). However, it is not known whether viral involvement in the liver differs according to the strain. We investigated the impact on liver injury in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Delta (B.1.617.2) variants.
Materials and Methods We conducted a single-center, retrospective cohort study, including 372 patients admitted during the pre-Delta period (PDP: between February 1 and November 30, 2020) and 137 patients admitted during the Delta period (DP: between August 1 and August 31, 2021). Initial liver injury was defined as alanine aminotransferase (ALT) or aspartate aminotransferase (AST) levels ≥3 × the upper limit of normal (ULN) or alkaline phosphatase (ALP) or total bilirubin ≥2 × the ULN within 3 days from admission.
Results Of 509 patients with COVID-19 included in our study, 38 (7.5%) patients had initial liver injury. The DP group had a significantly higher rate of initial liver injury than the PDP group (PDP: 5.9% vs. DP: 11.7%, P = 0.028). The DP group (adjusted odds ratio [aOR]: 2.737, 95% confidence interval [CI]: 1.322 – 5.666) was independently associated with initial liver injury. During hospitalization, 160 (31.4%) patients had severe COVID-19. The DP group and initial liver injury had higher odds of progressing to severe COVID-19 (aOR: 2.664, 95% CI: 1.526 - 4.648, and aOR: 4.409, 95% CI: 1.816 - 10.707, respectively). The mediation analysis suggested that initial liver injury mediates the relationship between SARS-CoV-2 Delta variant infection and severe COVID-19 (unstandardized beta coefficient = 0.980, Standard error = 0.284, P = 0.001).
Conclusion Initial liver injury is more common in COVID-19 patients with Delta variants. Also, Delta variants and initial liver injury are associated with poor clinical outcomes.
Background There is growing evidence that abnormal liver function tests (LFTs) are common in patients with coronavirus disease 2019 (COVID-19). However, it is not known whether viral involvement in the liver differs according to the strain. We investigated the impact on liver injury in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Delta (B.1.617.2) variants.
Materials and Methods We conducted a single-center, retrospective cohort study, including 372 patients admitted during the pre-Delta period (PDP: between February 1 and November 30, 2020) and 137 patients admitted during the Delta period (DP: between August 1 and August 31, 2021). Initial liver injury was defined as alanine aminotransferase (ALT) or aspartate aminotransferase (AST) levels ≥3 × the upper limit of normal (ULN) or alkaline phosphatase (ALP) or total bilirubin ≥2 × the ULN within 3 days from admission.
Results Of 509 patients with COVID-19 included in our study, 38 (7.5%) patients had initial liver injury. The DP group had a significantly higher rate of initial liver injury than the PDP group (PDP: 5.9% vs. DP: 11.7%, P = 0.028). The DP group (adjusted odds ratio [aOR]: 2.737, 95% confidence interval [CI]: 1.322 – 5.666) was independently associated with initial liver injury. During hospitalization, 160 (31.4%) patients had severe COVID-19. The DP group and initial liver injury had higher odds of progressing to severe COVID-19 (aOR: 2.664, 95% CI: 1.526 - 4.648, and aOR: 4.409, 95% CI: 1.816 - 10.707, respectively). The mediation analysis suggested that initial liver injury mediates the relationship between SARS-CoV-2 Delta variant infection and severe COVID-19 (unstandardized beta coefficient = 0.980, Standard error = 0.284, P = 0.001).
Conclusion Initial liver injury is more common in COVID-19 patients with Delta variants. Also, Delta variants and initial liver injury are associated with poor clinical outcomes.
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