Evidence map›Paper›PMID 35316959›Full record

Observational studyWorld journal of gastroenterology2022

Abnormal liver chemistries as a predictor of COVID-19 severity and clinical outcomes in hospitalized patients.

Arunkumar Krishnan, Laura Prichett, Xueting Tao, Saleh A Alqahtani, James P Hamilton, Esteban Mezey, Alexandra T Strauss, Ahyoung Kim, James J Potter, Po-Hung Chen and 1 more

Open access · hybridAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in World journal of gastroenterology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
32citing papers in PubMed, 1 pooled it
3.8field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

32 citing papers in PubMed, 1 synthesis or guideline pooled it, 38 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 2 institutions in 1 country.

Arunkumar KrishnanDivision of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States.
Laura PrichettDepartment of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States.
Xueting TaoDepartment of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States.
Saleh A AlqahtaniDivision of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States.
James P HamiltonDivision of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States.
Esteban MezeyDivision of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States.
Alexandra T StraussDivision of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States.
Ahyoung KimDivision of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States.
James J PotterDivision of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States.
Po-Hung ChenDivision of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States.
Tinsay A WoretaDivision of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States. tworeta1@jhmi.edu.
Johns Hopkins University · USJohns Hopkins Medicine · US

Funding

Candidate Selection for Liver Transplantation in Patients with Alcohol-related Liver DiseaseK23AA028297 · NIAAA · JOHNS HOPKINS UNIVERSITY · PI CHEN, PO-HUNG (VICTOR) · 2020 to 2024
$991k
NIAAA NIH HHS K23 AA028297
6 · The paper itself

Abstract

backgroundAbnormal liver chemistries are common findings in patients with Coronavirus Disease 2019 (COVID-19). However, the association of these abnormalities with the severity of COVID-19 and clinical outcomes is poorly understood.

aimWe aimed to assess the prevalence of elevated liver chemistries in hospitalized patients with COVID-19 and compare the serum liver chemistries to predict the severity and in-hospital mortality.

methodsThis retrospective, observational study included 3380 patients with COVID-19 who were hospitalized in the Johns Hopkins Health System (Baltimore, MD, United States). Demographic data, clinical characteristics, laboratory findings, treatment measures, and outcome data were collected. Cox regression modeling was used to explore variables associated with abnormal liver chemistries on admission with disease severity and prognosis.

resultsA total of 2698 (70.4%) had abnormal alanine aminotransferase (ALT) at the time of admission. Other more prevalent abnormal liver chemistries were aspartate aminotransferase (AST) (44.4%), alkaline phosphatase (ALP) (16.1%), and total bilirubin (T-Bil) (5.9%). Factors associated with liver injury were older age, Asian ethnicity, other race, being overweight, and obesity. Higher ALT, AST, T-Bil, and ALP levels were more commonly associated with disease severity. Multivariable adjusted Cox regression analysis revealed that abnormal AST and T-Bil were associated with the highest mortality risk than other liver injury indicators during hospitalization. Abnormal AST, T-Bil, and ALP were associated with a need for vasopressor drugs, whereas higher levels of AST, T-Bil, and a decreased albumin levels were associated with mechanical ventilation.

conclusionAbnormal liver chemistries are common at the time of hospital admission in COVID-19 patients and can be closely related to the patient's severity and prognosis. Elevated liver chemistries, specifically ALT, AST, ALP, and T-Bil levels, can be used to stratify risk and predict the need for advanced therapies in these patients.

Indexed as

COVID-19Alanine TransaminaseAlkaline PhosphataseAspartate AminotransferasesBaltimoreBilirubinHospitalizationHumansLiverRetrospective StudiesSeverity of Illness IndexAlanine TransaminaseAlkaline PhosphataseAspartate AminotransferasesBilirubinAlanine aminotransferaseAspartate aminotransferasebilirubinLiver injuryLiver testsSevere acute respiratory syndrome coronavirus 2

Identifiers

PMID35316959
PMCPMC8905016
OpenAlexW4206965382

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.