• Marco Vincenzo Lenti, Federica Borrelli de Andreis, Ivan Pellegrino, Catherine Klersy, Stefania Merli, Emanuela Miceli, Nicola Aronico, Caterina Mengoli, Michele Di Stefano, Sara Cococcia, Giovanni Santacroce, Simone Soriano, Federica Melazzini, Mariangela Delliponti, Fausto Baldanti, Antonio Triarico, Gino Roberto Corazza, Massimo Pinzani, Antonio Di Sabatino, and Internal Medicine Covid-19 Team.
• Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy.
• Intern Emerg Med. 2020 Nov 1; 15 (8): 139914071399-1407.

AbstractLittle is known regarding coronavirus disease 2019 (COVID-19) clinical spectrum in non-Asian populations. We herein describe the impact of COVID-19 on liver function in 100 COVID-19 consecutive patients (median age 70 years, range 25-97; 79 males) who were admitted to our internal medicine unit in March 2020. We retrospectively assessed liver function tests, taking into account demographic characteristics and clinical outcome. A patient was considered as having liver injury when alanine aminotransferase (ALT) was > 50 mU/ml, gamma-glutamyl transpeptidase (GGT) > 50 mU/ml, or total bilirubin > 1.1 mg/dl. Spearman correlation coefficient for laboratory data and bivariable analysis for mortality and/or need for intensive care were assessed. A minority of patients (18.6%) were obese, and most patients were non- or moderate-drinkers (88.5%). Liver function tests were altered in 62.4% of patients, and improved during follow-up. None of the seven patients with known chronic liver disease had liver decompensation. Only one patient developed acute liver failure. In patients with altered liver function tests, PaO2/FiO2 < 200 was associated with greater mortality and need for intensive care (HR 2.34, 95% CI 1.07-5.11, p = 0.033). To conclude, a high prevalence of altered liver function tests was noticed in Italian patients with COVID-19, and this was associated with worse outcomes when developing severe acute respiratory distress syndrome.

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