Association of coagulopathy with liver dysfunction in patients with COVID-19 - PubMed (original) (raw)

. 2021 Feb;51(2):227-232.

doi: 10.1111/hepr.13577. Epub 2020 Oct 27.

Makoto Saito 1, Hiroyuki Nagai 2, Shinya Yamamoto 1, Kazuhiko Ikeuchi 1, Lay Ahyoung Lim 2, Eisuke Adachi 2, Michiko Koga 1, Kazuya Okushin 3, Hiroyuki Akai 4, Akira Kunimatsu 4, Hiroshi Yotsuyanagi 1 2

Affiliations

Association of coagulopathy with liver dysfunction in patients with COVID-19

Takeya Tsutsumi et al. Hepatol Res. 2021 Feb.

Abstract

Aim: Liver dysfunction is sometimes observed in patients with coronavirus disease 2019 (COVID-19), but most studies are from China, and the frequency in other countries is unclear. In addition, previous studies suggested several mechanisms of liver damage, but precise or additional mechanisms are not clearly elucidated. Therefore, we examined COVID-19 patients to explore the proportion of patients with liver dysfunction and also the factors associated with liver dysfunction.

Methods: We retrospectively examined 60 COVID-19 patients hospitalized at the Hospital affiliated with The Institute of Medical Science, The University of Tokyo (Tokyo, Japan). Patients who presented ≥40 U/L alanine aminotransferase (ALT) levels at least once during their hospitalization were defined as high-ALT patients, and the others as normal-ALT patients. The worst values of physical and laboratory findings during hospitalization for each patient were extracted for the analyses. Univariable and multivariable logistic regression models with bootstrap (for 1000 times) were carried out.

Results: Among 60 patients, there were 31 (52%) high-ALT patients. The high-ALT patients were obese, and had significantly higher levels of D-dimer and fibrin/fibrinogen degradation products, as well as white blood cell count, and levels of C-reactive protein, ferritin, and fibrinogen. Multivariable analysis showed D-dimer and white blood cells as independent factors.

Conclusions: Considering that higher D-dimer level and white blood cell count were independently associated with ALT elevation, liver dysfunction in COVID-19 patients might be induced by microvascular thrombosis in addition to systemic inflammation.

Keywords: COVID-19; D-dimer; liver dysfunction; thrombosis.

© 2020 The Japan Society of Hepatology.

PubMed Disclaimer

Similar articles

Cited by

References

    1. Jothimani D, Venugopal R, Abedin MF, Kaliamoorthy I, Rela M. COVID‐19 and Liver. J Hepatol 2020; 73: 1231–1240. - PMC - PubMed
    1. Cai Q, Huang D, Yu H et al. COVID‐19: Abnormal liver function tests. J Hepatol 2020; 73: 566–574. - PMC - PubMed
    1. Mao R, Qiu Y, He JS et al. Manifestations and prognosis of gastrointestinal and liver involvement in patients with COVID‐19: a systematic review and meta‐analysis. Lancet Gastroenterol Hepatol 2020; 5: 667–678. - PMC - PubMed
    1. Portincasa P, Krawczyk M, Machill A, Lammert F, Di Ciaula A. Hepatic consequences of COVID‐19 infection. Lapping or biting? Eur J Intern Med 2020; 77: 18–24. - PMC - PubMed
    1. Park SH, Kim PN, Kin KW et al. Macrovesicular hepatic steatosis in living liver donors: Use of CT for quantitative and qualitative assessment. Radiology 2006; 239: 105–112. - PubMed

LinkOut - more resources