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• W3094387347 abstract "INTRODUCTION: Abnormal liver enzymes have been noted as a result of infection by the novel coronavirus-19 (COVID-19). This study examines the prevalence of abnormal liver enzymes at initial presentation in COVID-19 patients without known underlying chronic liver disease (CLD). METHODS: We reviewed charts of 11,265 adult patients with confirmed COVID-19 infection admitted to any of 12 hospitals in our health system from March 1 to April 30, 2020. COVID-19 status was confirmed by nasopharyngeal swabbing for PCR. Labs drawn within 24 hours of presentation were considered baseline. Patients that had an age less than 18, CLD-related ICD-10 codes, or missing baseline data were excluded. Abnormalities in liver chemistries were grouped as follows: (1) within normal limits; (2) mild: greater than the upper limit of normal (ULN) to less than or equal to 4 times the ULN; (3) moderate: greater than 4 times the ULN to less than or equal to 10 times the ULN; and (4) severe: greater than 10 times the ULN. Those with significant liver chemistry abnormalities were also grouped into patterns of injury based on ALT and alkaline phosphatase (ALP): hepatocellular (ALT >3x ULN and ALP ≤2x ULN), cholestatic (ALP >2x ULN and ALT ≤3x ULN), or mixed (ALT >3x ULN and ALP >2x ULN). RESULTS: 10,614 patients were included in our study. Over half of patients had elevations in AST (59%) and ALT (54%) on presentation, whereas ALP and total bilirubin were elevated in 13% and 5% of patients, respectively. The majority of patients had mild AST and ALT elevations as defined above (49% and 54%, respectively). Moderate elevations of AST (4.6%) and ALT (4.1%) were less common. Severe elevations in AST and ALT were seen in 0.8% of patients. 99% of ALP and total bilirubin elevations were mild. 3 patients presented with a total bilirubin greater than 10 X ULN. 936 patients (8.9%) presented with a hepatocellular pattern, 133 patients (1.3%) with a cholestatic pattern, and 91 patients (0.9%) with a mixed pattern. CONCLUSION: The majority of patients without known CLD presenting to the hospital with COVID-19 infection have abnormal liver chemistries. Most liver test abnormalities are mild with AST and ALT elevations more frequent than elevations in ALP and total bilirubin. The predominant pattern of liver injury was hepatocellular. Severe elevations of any biochemical liver tests are uncommon. The pathophysiology of these elevations need to be further studied to determine their etiology and whether certain enzyme patterns predict outcome." @default.
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• W3094387347 date "2020-10-01" @default.
• W3094387347 modified "2023-09-25" @default.
• W3094387347 title "S1097 Prevalence of Abnormal Liver Chemistries at Initial Presentation of COVID-19 Infection in Patients Without Known Chronic Liver Disease" @default.
• W3094387347 doi "https://doi.org/10.14309/01.ajg.0000706436.04010.5b" @default.
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