Factors Associated with Death among COVID-19 Patients with Acute Liver Injury

Abstract

Background: Acute liver injury can be found in patients infected with the novel corona virus (COVID-19). Some cases may have complications such as acute liver failure and death.

Objectives: The study aims to determine the risk factor of mortality among COVID-19 patients with liver injury.

Methods: The cross-sectional study design was used in this study among COVID-19 patients with acute hepatitis admitted to the Field hospital and Somdejphrajaotaksin Maharaj Hospital between March 2020 and September 2021. The data collected included the patient’s medical history and laboratory results. The analysis used was descriptive and inferential statistics including chi-square and logistic regression.

Results: The results showed that patients with advanced age (more than 60 years), hypoalbuminemia (≤3.5g/dL), hepatitis (aspartate aminotransferase (AST) > 40 U/L) and those with a length of hospital stay more than 7 days, showed a statistically significant association with death.Note that mortality showed the greatest effect size with hypoalbuminemia (ORadj =26.9; 95% CI=6.78-106.87), compared with other variables. The severity of coronavirus infection or alanine aminotransferase (ALT) > 40 U/L or alkaline phosphatase (ALP) > 126 U/L were no correlation to mortality.

Conclusion: Therefore, the treatment for COVID-19 patients with acute hepatitis should be prioritized for high-risk patients, especially the elderly, patients with hypoalbuminemia (≤3.5 g/dL), hepatitis (AST > 40 U/L) and patients with long admission more than 7 days, relative to other patients, to prevent mortality.