Background: Considering the rapid spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV2), the clinical implications of gastrointestinal (GI) and hepatic manifestations of coronavirus disease 2019 (COVID-19) in the U.S. population require analysis. Methods: We retrospectively reviewed all adult patients with COVID-19 admitted to our facility. Patients were divided into two groups based on the presence of GI symptoms and transaminitis at presentation. Univariable analysis was performed to assess the differences between study groups. Kruskal-Wallis and Pearson’s chi-square tests were used to compare the median of continuous and categorical variables, respectively. Multivariate logistic regression analysis was performed to identify predictors of mechanical ventilation, cytokine release syndrome (CRS), and mortality after adjusting for baseline variables. Results: A total of 84 patients were analyzed. After adjusting for baseline comorbidities, presence of GI symptoms (aOR, adjusted odds ratio 4.2, 95% CI, 1.17-15.60, p=0.03) and transaminitis on admission (aOR 5.69, 95% CI, 1.47-21.99, p=0.01) were associated with CRS. Transaminitis on admission and elevated total bilirubin during hospitalization were associated with an increased need for mechanical ventilation (aOR 6.17, 95% CI, 1.49-25.44, p=0.02 and aOR 7.29, 95% CI, 1.73-30.75, p=0.007, respectively). An elevated aspartate aminotransferase (AST) on admission (aOR 13.41, 95% CI, 1.08-165.69, p=0.04) and elevated total bilirubin during hospitalization (aOR 82.68, 95% CI, 1.67-4074.8, p=0.02) were independently associated with an increased risk of mortality in COVID-19 patients. Conclusion: COVID-19 patients with transaminitis on admission had a higher risk of requiring mechanical ventilation and developing CRS. Patients with elevated AST on admission and elevated total bilirubin had higher mortality. Patients with GI symptoms did not have worse outcomes.
【저자키워드】 coronavirus disease-2019, outcomes, Gastrointestinal, SARS- CoV2, hepatic manifestations, 【초록키워드】 COVID-19, coronavirus disease, coronavirus, SARS-CoV2, Mortality, mechanical ventilation, Hospitalization, Comorbidities, Cytokine release syndrome, Spread, Patient, Aspartate aminotransferase, AST, predictor, Admission, COVID-19 patients, CRS, Analysis, COVID-19 patient, manifestation, chi-square test, acute respiratory syndrome, adjusted odds ratio, Logistic regression analysis, higher risk, total bilirubin, 95% CI, increased risk, multivariate, transaminitis, study groups, Pearson, Kruskal-Wallis, analyzed, identify, elevated, was performed, were used, two group, baseline, clinical implication, GI symptom, patients with COVID-19, the median, variables, 【제목키워드】 COVID-19, experience, transaminase, Potential,