ArticleJournal of hepatology2021
Association of liver abnormalities with in-hospital mortality in patients with COVID-19.
Article in Journal of hepatology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 98 papers, 5 of them syntheses that pooled it.
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Who cites it
98 citing papers in PubMed, 5 syntheses or guidelines pooled it, 153 citations in OpenAlex.
- The impact of HBV infection on clinical outcomes of COVID-19 patients: a systematic review and meta-analysis.Epidemiology and infection · 2023Pooled it
- Effects of Hepatitis B Virus Infection on Patients with COVID-19: A Meta-Analysis.Digestive diseases and sciences · 2023Pooled it
- Liver injury associated with the severity of COVID-19: A meta-analysis.Frontiers in public health · 2023Pooled it
- Correlation between COVID-19 and hepatitis B: A systematic review.World journal of gastroenterology · 2022Pooled it
- A composite ranking of risk factors for COVID-19 time-to-event data from a Turkish cohort.Computational biology and chemistry · 2022Pooled it
- Effect of Subanesthetic Dose of Esketamine on Liver Function Following Microvascular Reconstruction for Head and Neck Cancer: A Randomized Controlled Trial.Drug design, development and therapy · 2025Trial
- Morphological and Immunohistochemical Characteristics of Liver Inflammation in Patients with a History of COVID-19.Viruses · 2026Article
- The prognostic value of liver function abnormalities in adult secondary hemophagocytic lymphohistiocytosis.Frontiers in medicine · 2026Article
- Influence of COVID-19 on endocrine and metabolic profiles in women with pathological ovarian aging.Journal of ovarian research · 2025Observational
- COVID-19 and Liver Injury, Beyond the First Pandemic Waves: Clinical and Immune-Virological Features.Journal of viral hepatitis · 2025Article
- Hepatitis B associated with severe COVID-19: a nationwide cohort study in Sweden.Virology journal · 2025Article
- Development and validation of a nomogram to assess the occurrence of liver dysfunction in patients with COVID-19 pneumonia in the ICU.BMC infectious diseases · 2025Article
- Characteristics and mechanisms of liver injury caused by emerging infectious diseases.Frontiers in immunology · 2025Review
- Clinical and CT image features for survival prediction in severe pneumonia during the SARS-CoV-2 Omicron wave.Frontiers in medicine · 2025Article
- The effect of SARS-CoV-2 infection on the liver function tests: a systematic review and meta-analysis of observational studies.Przeglad gastroenterologiczny · 2025Review
- SARS-CoV-2 Productively Infects Human Hepatocytes and Induces Cell Death.Journal of medical virology · 2025Article
- Liver function abnormality on admission predicts long COVID syndrome in digestive system.Heliyon · 2024Article
- Presence of cholestasis and its impact on survival in SARS-CoV-2 associated acute respiratory distress syndrome.Scientific reports · 2024Article
- The Model for End-Stage Liver Disease (MELD) Score Predicting Mortality Due to SARS-CoV-2 in Mexican Patients.Journal of clinical medicine · 2024Article
- Immune Response and Risk of Decompensation following SARS-CoV-2 Infection in Outpatients with Advanced Chronic Liver Disease.International journal of molecular sciences · 2024Observational
38 more citing papers are in PubMed but not listed here.
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Authors and funding
29 authors at 6 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND &
aimsThe evolution and clinical significance of abnormal liver chemistries and the impact of hepatitis B infection on outcome in patients with COVID-19 is not well characterized. This study aimed to explore these issues.
methodsThis large retrospective cohort study included 2,073 patients with coronavirus disease 2019 (COVID-19) and definite outcomes in Wuhan, China. Longitudinal liver function tests were conducted, with associated factors and risk of death determined by multivariate regression analyses. A prognostic nomogram was formulated to predict the survival of patients with COVID-19. The characteristics of liver abnormalities and outcomes of patients with COVID-19, with and without hepatitis B, were compared after 1:3 propensity score matching.
resultsOf the 2,073 patients, 1,282 (61.8%) had abnormal liver chemistries during hospitalization, and 297 (14.3%) had a liver injury. The mean levels of aspartate aminotransferase (AST) and direct bilirubin (D-Bil) increased early after symptom onset in deceased patients and showed disparity compared to levels in discharged patients throughout the clinical course of the disease. Abnormal AST (adjusted hazard ratio [HR] 1.39; 95% CI 1.04-1.86, p = 0.027) and D-Bil (adjusted HR 1.66; 95% CI 1.22-2.26; p = 0.001) levels at admission were independent risk factors for mortality due to COVID-19. A nomogram was established based on the results of multivariate analysis and showed sufficient discriminatory power and good consistency between the prediction and the observation. HBV infection in patients did not increase the risk of poor COVID-19-associated outcomes.
conclusionsAbnormal AST and D-Bil levels at admission were independent predictors of COVID-19-related mortality. Therefore, monitoring liver chemistries, especially AST and D-Bil levels, is necessary in hospitalized patients with COVID-19. LAY SUMMARY: Liver test abnormalities (in particular elevations in the levels of aspartate aminotransferase [AST] and direct bilirubin [D-Bil]) were observed after symptom onset in patients who went on to die of coronavirus disease 2019 (COVID-19). Abnormal levels of AST and D-Bil at admission were independent predictors of COVID-19-related mortality. HBV infection in patients did not increase the risk of poor COVID-19-associated outcomes.
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