Association Between Drug Treatments and the Incidence of Liver Injury in Hospitalized Patients With COVID-19

Suyu Gao; Qingqing Yang; Xuanxuan Wang; Wen Hu; Yun Lu; Kun Yang; Qiaoli Jiang; Wenjing Li; Haibo Song; Feng Sun; Hong Cheng

doi:10.3389/fphar.2022.799338

Association Between Drug Treatments and the Incidence of Liver Injury in Hospitalized Patients With COVID-19

Front Pharmacol. 2022 Mar 21:13:799338. doi: 10.3389/fphar.2022.799338. eCollection 2022.

Authors

Suyu Gao¹, Qingqing Yang², Xuanxuan Wang¹, Wen Hu¹, Yun Lu¹, Kun Yang¹, Qiaoli Jiang¹, Wenjing Li¹, Haibo Song^{3

4}, Feng Sun², Hong Cheng¹

Affiliations

¹ Department of Pharmacy, Zhongnan Hospital of Wuhan University, Wuhan, China.
² Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.
³ Key Laboratory for Research and Evaluation of Pharmacovigilance, National Medical Products Administration, Beijing, China.
⁴ Chinese Society of Toxicology, Beijing, China.

Abstract

The outbreak of coronavirus disease 2019 (COVID-19) has led to the emergence of global health care. In this study, we aimed to explore the association between drug treatments and the incidence of drug-induced liver injury (DILI) in hospitalized patients with COVID-19. A retrospective study was conducted on 5113 COVID-19 patients in Hubei province, among which 395 incurred liver injury. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated by Cox proportional hazards models. The results showed that COVID-19 patients who received antibiotics (HR 1.97, 95% CI: 1.55-2.51, p < 0.001), antifungal agents (HR 3.10, 95% CI: 1.93-4.99, p < 0.001) and corticosteroids (HR 2.31, 95% CI: 1.80-2.96, p < 0.001) had a higher risk of DILI compared to non-users. Special attention was given to the use of parenteral nutrition (HR 1.82, 95% CI: 1.31-2.52, p < 0.001) and enteral nutrition (HR 2.71, 95% CI: 1.98-3.71, p < 0.001), which were the risk factors for liver injury. In conclusion, this study suggests that the development of DILI in hospitalized patients with COVID-19 needs to be closely monitored, and the above-mentioned drug treatments may contribute to the risk of DILI.

Keywords: COVID-19; drug treatment; drug-induced liver injury (DILI); multi-center retrospective study; risk factors.