Prevalence of hepatopancreatic injury and clinical outcomes in patients with COVID-19 in USA

Vaibhav Rastogi; Ranjit Banwait; Devina Singh; Hale Toklu; Lexie Finer; Dipendra Parajuli; Latha Ganti

doi:10.1186/s12245-021-00393-2

Prevalence of hepatopancreatic injury and clinical outcomes in patients with COVID-19 in USA

Int J Emerg Med. 2021 Nov 6;14(1):68. doi: 10.1186/s12245-021-00393-2.

Authors

Vaibhav Rastogi^{1

2}, Ranjit Banwait³, Devina Singh³, Hale Toklu^{1

3}, Lexie Finer¹, Dipendra Parajuli⁴, Latha Ganti^{5

6

7}

Affiliations

¹ HCA Healthcare Graduate Medical Education, Nashville, Tennessee, USA.
² Envision Physician Services, Plantation, Florida, USA.
³ Department of Clinical Sciences, University of Central Florida College of Medicine, Florida, Orlando, USA.
⁴ Department of Gastroenterology, University of Louisville, Louisville, Kentucky, USA.
⁵ HCA Healthcare Graduate Medical Education, Nashville, Tennessee, USA. Latha.Ganti@ucf.edu.
⁶ Envision Physician Services, Plantation, Florida, USA. Latha.Ganti@ucf.edu.
⁷ Department of Clinical Sciences, University of Central Florida College of Medicine, Florida, Orlando, USA. Latha.Ganti@ucf.edu.

Abstract

Background: (1) To determine the prevalence of hepatopancreatic injury in coronavirus disease 2019 (COVID-19) patients. (2) To correlate hepatopancreatic injury in COVID-19 with mortality, disease severity, and length of stay in this cohort.

Results: Forty-five thousand three hundred sixty patients were included in the analysis, 62.82% of which had either hepatic or pancreatic injury. There was a significant upward trend in transaminases, alkaline phosphatase, prothrombin time, bilirubin, lactate dehydrogenase, and lipase and a downward trend in albumin with an increase in disease severity. COVID-19-positive patients with hepato-pancreatic injury have a significantly higher mortality (OR 3.39, 95%CI 3.15-3.65) after controlling for the differences in age, sex, race/ethnicity, liver cirrhosis, and medication exposures. They also have increased disease severity (OR 2.7, 95%CI 2.5-2.9 critical vs mild/moderate; OR 1.4, 95% CI 1.3-1.5 severe vs mild/moderate) and longer hospital length of stay (2 days).

Conclusion: COVID-19 can cause liver injury. Mortality, disease severity, and hospital length of stay are increased in COVID-19 patients with hepatopancreatic injury.

Keywords: Liver; Mortality; Pancreas; SARS-CoV2.