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All Studies   Meta Analysis    Recent:   
0 0.5 1 1.5 2+ Liver damage -167% Improvement Relative Risk Acetaminophen for COVID-19  Leo et al.  LATE TREATMENT Is late treatment with acetaminophen beneficial for COVID-19? Retrospective 292 patients in Switzerland Higher progression with acetaminophen (p=0.004) c19early.org Leo et al., Digestive and Liver Disease, May 2022 Favors acetaminophen Favors control

Hepatocellular liver injury in hospitalized patients affected by COVID-19: Presence of different risk factors at different time points

Leo et al., Digestive and Liver Disease, doi:10.1016/j.dld.2021.12.014
May 2022  
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1st treatment shown to increase risk in November 2020
 
*, now known with p = 0.00000029 from 27 studies, but still recommended in 46 countries.
* From meta analysis with ≥3 clinical studies.
4,200+ studies for 70+ treatments. c19early.org
Retrospective 292 patients in Switzerland showing liver damage associated with acetaminophen treatment and remdesivir treatment.
Acetaminophen is also known as paracetamol, Tylenol, Panadol, Calpol, Tempra, Calprofen, Doliprane, Efferalgan, Grippostad C, Dolo, Acamol, Fevadol, Crocin, and Perfalgan.
Study covers acetaminophen and remdesivir.
risk of liver damage, 167.0% higher, OR 2.67, p = 0.004, treatment 190, control 102, adjusted per study, multivariable, RR approximated with OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Leo et al., 31 May 2022, retrospective, Switzerland, peer-reviewed, 7 authors. Contact: massimo.leo@aphp.fr.
This PaperAcetaminophenAll
Hepatocellular liver injury in hospitalized patients affected by COVID-19: Presence of different risk factors at different time points
M Leo, A Galante, A Pagnamenta, L Ruinelli, F R Ponziani, A Gasbarrini, A De Gottardi
Digestive and Liver Disease, doi:10.1016/j.dld.2021.12.014
Background: Prevalence and clinical impact of increased liver function tests in patients affected by Coronavirus disease 2019 (COVID-19) is controversial. Aims: This observational study evaluates the prevalence of transaminases elevation in hospitalized patients affected by COVID-19 and investigates the presence of factors associated with hepatocellular injury and with mortality. Methods: Data of 292 adult patients with confirmed COVID-19 admitted to the Ente Ospedaliero Cantonale (Switzerland) were retrospectively analyzed. Results: Transaminases were increased in about one-third of patients on hospital admission and twothirds of patients during the hospital stay. On hospital admission, transaminases were more commonly elevated in younger patients, who also reported elevated C reactive protein and a higher degree of respiratory failure. Independent factors associated with abnormal transaminases during hospitalization were drugs, in particular paracetamol (OR = 2.67; 95% CI = 1.38-5.18; p = 0.004) and remdesivir (OR = 5.16; 95% CI = 1.10-24.26; p = 0.04). Mortality was independently associated to age (OR = 1.09; 95% CI = 1.05-1.13; p < 0.001), admission to intensive care unit (OR = 5.22; 95% CI = 2.28-11.90; p < 0.001) and alkaline phosphatase peak (OR = 1.01; 95% CI = 1.00-1.01; p = 0.01). Conclusions: On hospital admission, factors associated with liver damage were linked to demographic and clinical characteristics (age, inflammation and hypoxia) while, during hospitalization, drug treatment was related to development and progression of hepatocellular damage. Mortality was associated with alkaline phosphate peak value.
Conflict of Interest Massimo Leo, Antonio Galante, Alberto Pagnamenta, Lorenzo Ruinelli, Francesca Romana Ponziani, Antonio Gasbarrini and Andrea De Gottardi declare that there are no conflicts of interest.
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Late treatment
is less effective
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