Clinical Predictors for Abnormal ALT in Patients Infected with COVID-19—A Retrospective Single Centre Study

DOI record: { "DOI": "10.3390/pathogens12030473", "ISSN": [ "2076-0817" ], "URL": "http://dx.doi.org/10.3390/pathogens12030473", "abstract": "<jats:p>Objective: Abnormal liver tests have been associated with worse clinical outcomes in patients infected with COVID-19. This retrospective observational study from Singapore aims to elucidate simple clinical predictors of abnormal alanine aminotransferase (ALT) in COVID-19 infections. Design: 717 patients hospitalised with COVID-19 at the National Centre for Infectious Diseases (NCID), Singapore, from 23 January–15 April 2020 were screened, of which 163 patients with baseline normal alanine transferase (ALT) and at least two subsequent ALTs performed were included in the final analysis. Information on baseline demographics, clinical characteristics and biochemical laboratory tests were collected. Results: 30.7% of patients developed abnormal ALT. They were more likely to be older (60 vs. 55, p = 0.022) and have comorbidities of hyperlipidaemia and hypertension. The multivariate logistic regression showed that R-factor ≥1 on admission (adjusted odds ratio (aOR) 3.13, 95% Confidence Interval (CI) 1.41–6.95) and hypoxia (aOR 3.54, 95% CI 1.29–9.69) were independent risk factors for developing abnormal ALT. The patients who developed abnormal ALT also ran a more severe course of illness with a greater proportion needing supplementary oxygen (58% vs. 18.6%, p &lt; 0.0005), admission to the Intensive Care Unit (ICU)/High Dependency Unit (HDU) (32% vs. 11.5%, p = 0.003) and intubation (20% vs. 2.7%, p &lt; 0.0005). There was no difference in death rate between the two groups. Conclusions: Liver injury is associated with poor clinical outcomes in patients with COVID-19. R-factor ≥1 on admission and hypoxia are independent simple clinical predictors for developing abnormal ALT in COVID-19.</jats:p>", "alternative-id": [ "pathogens12030473" ], "author": [ { "affiliation": [ { "name": "Department of Gastroenterology & Hepatology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore" } ], "family": "Chew", "given": "Wei Da", "sequence": "first" }, { "affiliation": [ { "name": "Department of Gastroenterology & Hepatology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore" } ], "family": "Kuang", "given": "Jonathan", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Gastroenterology & Hepatology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore" } ], "family": "Lin", "given": "Huiyu", "sequence": "additional" }, { "ORCID": "http://orcid.org/0000-0002-0036-255X", "affiliation": [ { "name": "National Centre for Infectious Diseases, 16 Jalan Tan Tock Seng, Singapore 308442, Singapore" } ], "authenticated-orcid": false, "family": "Ang", "given": "Li Wei", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Gastroenterology & Hepatology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore" } ], "family": "Yang", "given": "Wei Lyn", "sequence": "additional" }, { "ORCID": "http://orcid.org/0000-0003-0324-0205", "affiliation": [ { "name": "National Centre for Infectious Diseases, 16 Jalan Tan Tock Seng, Singapore 308442, Singapore" }, { "name": "Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 636921, Singapore" } ], "authenticated-orcid": false, "family": "Lye", "given": "David C.", "sequence": "additional" }, { "affiliation": [ { "name": "National Centre for Infectious Diseases, 16 Jalan Tan Tock Seng, Singapore 308442, Singapore" }, { "name": "Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 636921, Singapore" } ], "family": "Young", "given": "Barnaby E.", "sequence": "additional" } ], "container-title": "Pathogens", "container-title-short": "Pathogens", "content-domain": { "crossmark-restriction": false, "domain": [] }, "created": { "date-parts": [ [ 2023, 3, 17 ] ], "date-time": "2023-03-17T06:59:26Z", "timestamp": 1679036366000 }, "deposited": { "date-parts": [ [ 2023, 3, 17 ] ], "date-time": "2023-03-17T09:46:25Z", "timestamp": 1679046385000 }, "indexed": { "date-parts": [ [ 2023, 3, 18 ] ], "date-time": "2023-03-18T04:38:55Z", "timestamp": 1679114335454 }, "is-referenced-by-count": 0, "issue": "3", "issued": { "date-parts": [ [ 2023, 3, 16 ] ] }, "journal-issue": { "issue": "3", "published-online": { "date-parts": [ [ 2023, 3 ] ] } }, "language": "en", "license": [ { "URL": "https://creativecommons.org/licenses/by/4.0/", "content-version": "vor", "delay-in-days": 0, "start": { "date-parts": [ [ 2023, 3, 16 ] ], "date-time": "2023-03-16T00:00:00Z", "timestamp": 1678924800000 } } ], "link": [ { "URL": "https://www.mdpi.com/2076-0817/12/3/473/pdf", "content-type": "unspecified", "content-version": "vor", "intended-application": "similarity-checking" } ], "member": "1968", "original-title": [], "page": "473", "prefix": "10.3390", "published": { "date-parts": [ [ 2023, 3, 16 ] ] }, "published-online": { "date-parts": [ [ 2023, 3, 16 ] ] }, "publisher": "MDPI AG", "reference": [ { "key": "ref_1", "unstructured": "(2023, January 19). 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