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Oral 11 Liver Injury Is Associated With Increased Morbidity and Mortality in COVID-19 Patients
Author Insight from Mohammad Siddiqui, MD, Henry Ford Hospital
What’s new here and important for clinicians?
We know that there is a high prevalence of liver injury in patients with COVID-19. However only a few studies have evaluated risk factors and clinical outcomes associated with liver injury. Our study follows a large cohort of hospitalized patients with COVID-19 to address these areas of interest. We found that liver injury was common, occurring in 20.5% of hospitalized patients with COVID-19. Men and African Americans with COVID-19 were more likely to develop liver injury.
Moreover, patients who manifested liver injury were also at significantly increased risk for mortality as well as other poor clinical outcomes including ICU admission, intubation, 30-day readmission, length of hospitalization and ICU stay.
As of now, treatment for COVID-19 is mainly supportive with consideration of anti-inflammatory agents, immunomodulatory therapies, certain antivirals, and antibody therapy such as convalescent plasma. Until a vaccine is developed and clinical trials on treatments yield more established and convincing treatment algorithms, prognostication of patients is critical. Clinicians caring for patients with COVID-19 should consider routinely monitoring liver enzymes as that may assist with risk stratification and medical decision making.
What do patients need to know?
Patients should know that COVID-19 is a systemic illness that can affect a variety of organs including the liver. Individuals with liver involvement from COVID-19 appear to be at greater risk for adverse outcomes including death. For this reason, patients with suspected or confirmed COVID-19 should seek prompt medical attention and be followed by experienced physicians. Patients should report any symptoms, respiratory or non-respiratory, to their physicians. In addition, all efforts should be made to minimize the spread of the virus across our community by following CDC guidelines including social distancing, wearing face masks and practicing hand hygiene.