Pre-existing Liver Diseases and On-Admission Liver-Related Laboratory Tests in COVID-19: A Prognostic Accuracy Meta-Analysis With Systematic Review

Background: We aimed to perform a systematic search and meta-analysis to evaluate the prognostic value of on-admission liver function tests and pre-existing liver diseases on the clinical course of coronavirus disease 2019 (COVID-19). Methods: The study was registered on PROSPERO (CRD42020182902). W...

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Detalles Bibliográficos
Autores principales: Váncsa, Szilárd, Hegyi, Péter Jeno, Zádori, Noémi, Szakó, Lajos, Vörhendi, Nóra, Ocskay, Klementina, Földi, Mária, Dembrovszky, Fanni, Dömötör, Zsuzsa Réka, Jánosi, Kristóf, Rakonczay, Zoltán, Hartmann, Petra, Horváth, Tamara, Erőss, Bálint, Kiss, Szabolcs, Szakács, Zsolt, Németh, Dávid, Hegyi, Péter, Pár, Gabriella
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2020
Materias:
Medicine
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7691431/
https://www.ncbi.nlm.nih.gov/pubmed/33282888
http://dx.doi.org/10.3389/fmed.2020.572115
Descripción
Sumario:Background: We aimed to perform a systematic search and meta-analysis to evaluate the prognostic value of on-admission liver function tests and pre-existing liver diseases on the clinical course of coronavirus disease 2019 (COVID-19). Methods: The study was registered on PROSPERO (CRD42020182902). We searched five databases between 01/01/2020 and 04/23/2020. Studies that reported on liver-related comorbidities and/or laboratory parameters in patients with COVID-19 were included. The main outcomes were COVID-19 severity, intensive care unit (ICU) admission, and in-hospital mortality. Analysis of predictive models hierarchical summary receiver-operating characteristic (HSROC) was conducted with a 95% confidence interval (CI). Results: Fifty studies were included in the meta-analysis. High specificity was reached by acute liver failure associated by COVID-19 (0.94, 95% CI: 0.71–0.99) and platelet count (0.94, 95% CI: 0.71–0.99) in the case of mortality; chronic liver disease (CLD) (0.98, 95% CI: 0.96–0.99) and platelet count (0.82, 95% CI: 0.72–0.89) in the case of ICU requirement; and CLD (0.97, 95% CI: 0.95–0.98), chronic hepatitis B infection (0.97, 95% CI: 0.95–0.98), platelet count (0.86, 95% CI: 0.77–0.91), and alanine aminotransferase (ALT) (0.80, 95% CI: 0.66–0.89) and aspartate aminotransferase (AST) (0.84, 95% CI: 0.77–0.88) activities considering severe COVID-19. High sensitivity was found in the case of C-reactive protein (CRP) for ICU requirement (0.92, 95% CI: 0.80–0.97) and severe COVID-19 (0.91, 95% CI: 0.82–0.96). Conclusion: On-admission platelet count, ALT and AST activities, CRP concentration, and the presence of acute and CLDs predicted the severe course of COVID-19. To highlight, pre-existing liver diseases or acute liver injury associated by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection plays an important role in the prediction of mortality.

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