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Liver Injury in Hospitalized Patients with COVID-19 Correlates with Hyper Inflammatory Response and Elevated IL-6.

ABSTRACT:

Background

Liver injury is commonly seen in coronavirus disease 2019 (COVID-19). However, the mechanism behind liver injury, particularly in severe and critical COVID-19 patients, remains unclear and the clinical course is poorly described.

Methods

We conducted a single-center, retrospective cohort study of consecutive hospitalized severe and critically ill COVID-19 patients with or without liver injury who underwent immunologic testing (IL-6, IL-8, TNF-?, and IL-1ß). Liver injury was defined as peak aminotransferases ?3x ULN (40 U/L) or ?120 U/L. Patients with liver injury were compared to those who had normal aminotransferases throughout the hospital course.

Results

176 patients were studied; 109 with liver injury and 67 controls. Patients with liver injury were more likely to be male (71.6% vs 37.3%; p < 0.001). Peak inflammatory markers and IL-6 were higher in the liver injury group: CRP: 247 vs 168 mg/L, p < 0.001; LDH: 706 vs 421 U/L, ferritin: 2,973 vs 751 ng/mL, p < 0.001, IL-6: 121.0 vs 71.8, p < 0.001. There was no difference in the levels of IL-8, TNF-?, and IL-1ß. The liver injury group had a longer length of stay and more severe COVID-19 despite having less diabetes and chronic kidney disease.

Discussion

An exaggerated hyper inflammatory response (cytokine storm) characterized by significantly elevated CRP, LDH, ferritin, and IL-6 levels and increasing severity of COVID-19 appears to be associated with the occurrence of liver injury in patients with severe/ critical COVID-19.

SUBMITTER: Da BL

PROVIDER: S-EPMC7675519 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

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Liver Injury in Patients Hospitalized with Coronavirus Disease 2019 Correlates with Hyperinflammatory Response and Elevated Interleukin-6.

Da Ben L BL Kushner Tatyana T El Halabi Maan M Paka Pavan P Khalid Mian M Uberoi Angad A Lee Brian T BT Perumalswami Ponni V PV Rutledge Stephanie M SM Schiano Thomas D TD Friedman Scott L SL Saberi Behnam B

Hepatology communications 20201210 2

Liver injury is commonly seen in coronavirus disease 2019 (COVID-19); however, the mechanism behind liver injury, particularly in patients with severe and critical COVID-19, remains unclear, and the clinical course is poorly described. We conducted a single-center retrospective cohort study of consecutive patients hospitalized with severe and critical COVID-19 with or without liver injury and who underwent immunologic testing (interleukin [IL]-6, IL-8, tumor necrosis factor alpha [TNF-α], and IL ...[more]

PMID: 33230491

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