Effects of COVID-19 on the Liver and Mortality in Patients with SARS-CoV-2 Pneumonia Caused by Delta and Non-Delta Variants: An Analysis in a Single Centre

{ 'indexed': { 'date-parts': [[2023, 12, 21]], 'date-time': '2023-12-21T00:25:58Z', 'timestamp': 1703118358241}, 'reference-count': 80, 'publisher': 'MDPI AG', 'issue': '1', 'license': [ { 'start': { 'date-parts': [[2023, 12, 19]], 'date-time': '2023-12-19T00:00:00Z', 'timestamp': 1702944000000}, 'content-version': 'vor', 'delay-in-days': 0, 'URL': 'https://creativecommons.org/licenses/by/4.0/'}], 'funder': [ { 'name': 'Increasing the Performance of Scientific Research, Supporting Excellence in Medical ' 'Research and Innovation', 'award': ['PDI-PFE-CDI 2021', '0PFE/30.12.2021']}], 'content-domain': {'domain': [], 'crossmark-restriction': False}, 'abstract': '<jats:p>The aim of this study was to ascertain patient characteristics, outcomes, and liver ' 'injuries in patients infected with different SARS-CoV-2 variants. Data from consecutive adult ' 'patients with severe/critical COVID-19 admitted to our hospital during the peak month of the ' 'Delta wave were compared to the ancestral, Alpha, and Omicron waves. The dataset of 551 ' 'hospitalized patients was similar in the Delta/non-Delta waves. At admission and discharge, ' 'the median aminotransferase levels were normal or slightly increased. During the Delta wave ' '(172 vs. 379 non-Delta patients), more patients died (OR 1.69, 95%CI 1.09–2.56) or had liver ' 'injury at discharge (alanine aminotransferase, ALT ≥ 2 ULN) (OR 1.97, 95%CI 1.08–3.54). ' 'In-hospital mortality was associated with age, lung injury, intensive care unit admission, ' 'number of and cardiovascular comorbidities, diabetes, chronic kidney disease, and all ' 'inflammatory biomarkers. Serious liver injury at admission (ALT ≥ 5 × ULN) was significantly ' 'associated with in-hospital mortality (OR = 7.9, 95%CI 2–28.9). At discharge, drug-induced ' 'liver injury (DILI) was found in patients treated with remdesivir, ALT ≥ 2 ULN (OR = 2.62, ' '95%CI 1.22–5.75). Treatment with dexamethasone, remdesivir, and immunomodulators showed ' 'improved survival, OR = 0.50 (95%CI 0.33–0.77). Regardless of the variant and treatment ' 'options, less than 2% of patients displayed serious liver injury, which was not found to be a ' 'death predictor in multivariable analysis.</jats:p>', 'DOI': '10.3390/ph17010003', 'type': 'journal-article', 'created': { 'date-parts': [[2023, 12, 19]], 'date-time': '2023-12-19T16:17:24Z', 'timestamp': 1703002644000}, 'page': '3', 'source': 'Crossref', 'is-referenced-by-count': 0, 'title': 'Effects of COVID-19 on the Liver and Mortality in Patients with SARS-CoV-2 Pneumonia Caused by ' 'Delta and Non-Delta Variants: An Analysis in a Single Centre', 'prefix': '10.3390', 'volume': '17', 'author': [ { 'given': 'Monica', 'family': 'Muntean', 'sequence': 'first', 'affiliation': [ { 'name': 'Department of Infectious Diseases and Epidemiology, The “Iuliu ' 'Hatieganu” University of Medicine and Pharmacy, 400348 ' 'Cluj-Napoca, Romania'}, { 'name': 'The Teaching Hospital of Infectious Diseases, 400348 ' 'Cluj-Napoca, Romania'}]}, { 'given': 'Violeta', 'family': 'Briciu', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Infectious Diseases and Epidemiology, The “Iuliu ' 'Hatieganu” University of Medicine and Pharmacy, 400348 ' 'Cluj-Napoca, Romania'}, { 'name': 'The Teaching Hospital of Infectious Diseases, 400348 ' 'Cluj-Napoca, Romania'}]}, { 'ORCID': 'http://orcid.org/0000-0003-4010-2901', 'authenticated-orcid': False, 'given': 'Mihaela', 'family': 'Lupse', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Infectious Diseases and Epidemiology, The “Iuliu ' 'Hatieganu” University of Medicine and Pharmacy, 400348 ' 'Cluj-Napoca, Romania'}, { 'name': 'The Teaching Hospital of Infectious Diseases, 400348 ' 'Cluj-Napoca, Romania'}]}, { 'ORCID': 'http://orcid.org/0000-0001-6067-5307', 'authenticated-orcid': False, 'given': 'Doina', 'family': 'Colcear', 'sequence': 'additional', 'affiliation': [ { 'name': 'The Teaching Hospital of Infectious Diseases, 400348 ' 'Cluj-Napoca, Romania'}]}, { 'ORCID': 'http://orcid.org/0009-0002-9730-3333', 'authenticated-orcid': False, 'given': 'Raul Vlad', 'family': 'Macicasan', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Infectious Diseases and Epidemiology, The “Iuliu ' 'Hatieganu” University of Medicine and Pharmacy, 400348 ' 'Cluj-Napoca, Romania'}]}, { 'given': 'Agnes', 'family': 'Csiszer', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Infectious Diseases and Epidemiology, The “Iuliu ' 'Hatieganu” University of Medicine and Pharmacy, 400348 ' 'Cluj-Napoca, Romania'}]}, { 'given': 'Alexandra', 'family': 'Manole', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Infectious Diseases and Epidemiology, The “Iuliu ' 'Hatieganu” University of Medicine and Pharmacy, 400348 ' 'Cluj-Napoca, Romania'}]}, { 'ORCID': 'http://orcid.org/0000-0002-4154-0498', 'authenticated-orcid': False, 'given': 'Amanda', 'family': 'Radulescu', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Infectious Diseases and Epidemiology, The “Iuliu ' 'Hatieganu” University of Medicine and Pharmacy, 400348 ' 'Cluj-Napoca, Romania'}, { 'name': 'The Teaching Hospital of Infectious Diseases, 400348 ' 'Cluj-Napoca, Romania'}]}], 'member': '1968', 'published-online': {'date-parts': [[2023, 12, 19]]}, 'reference': [ { 'key': 'ref_1', 'first-page': '760', 'article-title': 'COVID-19 and indirect liver injury: A narrative synthesis of the ' 'evidence', 'volume': '9', 'author': 'Idalsoaga', 'year': '2021', 'journal-title': 'J. 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