Liver dysfunction and clinical outcomes of unvaccinated COVID-19 patients with and without chronic hepatitis B.
J Microbiol Immunol Infect
; 57(1): 55-63, 2024 Feb.
Article
em En
| MEDLINE
| ID: mdl-38110321
ABSTRACT
BACKGROUND:
Liver dysfunction is common during coronavirus disease 2019 (COVID-19), while its clinical impact and association with chronic hepatitis B (CHB) remain uncertain. We aimed to investigate liver dysfunction in COVID-19 patients and its impacts on those with/without CHB.METHODS:
We conducted a retrospective cohort study of COVID-19 patients at National Taiwan University Hospital, stratified according to hepatitis B surface antigen (HBsAg) serostatus, with demographics, laboratory data, and hospitalization course reviewed, and clinical outcomes compared through multivariable analyses.RESULTS:
We enrolled 109 COVID-19 patients unvaccinated against SARS-CoV-2 by August 2021. The HBsAg-positive group (n = 34) had significantly higher alanine aminotransferase (ALT) (26 vs. 16 U/L, P = 0.034), platelet (224 vs. 183 k/µL, P = 0.010) and longer hospitalizations (17 vs. 13 days, P = 0.012) compared with HBsAg-negative group (n = 75), while percentages of hepatitis (2-fold ALT elevation), oxygen supplementation, ventilators usage, COVID-specific treatment, intensive care unit (ICU) admission and mortality were comparable. Older age (odds ratio [OR] 1.04, 95 % confidence interval [CI] 1.00-1.08, P = 0.032) and higher aspartate aminotransferase (AST) (OR 1.08, 95 % CI 1.004-1.16, P = 0.038) were associated with oxygen supplementation according to multivariable analyses. Higher AST predicted ICU admission (OR 1.11, 95 % CI 1.03-1.19, P = 0.008). Oxygen usage (OR 5.64, 95 % CI 1.67-19.09, P = 0.005) and shock (OR 5.12, 95 % CI 1.14-22.91, P = 0.033) were associated with liver dysfunction.CONCLUSIONS:
CHB patients had higher ALT levels and longer hospitalizations during COVID-19. Higher AST levels predict severe COVID-19 and ICU admission.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Hepatite B Crônica
/
COVID-19
Limite:
Humans
Idioma:
En
Revista:
J Microbiol Immunol Infect
Assunto da revista:
ALERGIA E IMUNOLOGIA
/
MICROBIOLOGIA
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Taiwan