Clinical outcome and risk assessment in hospitalized COVID-19 patients with elevated transaminases and acute kidney injury: A single center study

Authors

Yulia Khruleva, Department of Internal Diseases, Peoples` Friendship University of Russia, Moscow, Russia.
Zhanna Kobalava, Department of Internal Diseases, Peoples` Friendship University of Russia, Moscow, Russia.
Olga Arisheva, Department of Internal Diseases, Peoples` Friendship University of Russia, Moscow, Russia.
Marina Efremovtseva, Department of Internal Diseases, Peoples` Friendship University of Russia, Moscow, Russia.
Irina Garmash, Department of Internal Diseases, Peoples` Friendship University of Russia, Moscow, Russia.
Maria Vatsik-Gorodetskaya, Department of Cardiology, Russian Clinical and Research Center of Gerontology, Pirogov`s Russian National Research Medical University, Moscow, Russia.
Mohammed Al Jarallah, Department of Cardiology, Sabah Al Ahmed Cardiac Centre, Kuwait City, Kuwait.Follow
Peter A. Brady, Advocate Aurora HealthFollow
Ibrahim Al-Zakwani, Department of Pharmacology and Clinical Pharmacy, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman.Follow
Rajesh Rajan, Department of Internal Diseases, Peoples` Friendship University of Russia, Moscow, Russia.

Recommended Citation

Khruleva Y, Kobalava Z, Arisheva O, et al. Clinical Outcome and Risk Assessment in Hospitalized COVID-19 Patients with Elevated Transaminases and Acute Kidney Injury: A Single Center Study. Oman Med J. 2022;37(6):e443. Published 2022 Nov 30. doi:10.5001/omj.2022.98

Affiliations

Illinois Masonic Medical Center

Abstract

Objectives:Initial reports indicate a high incidence of abnormal aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels in patients with COVID-19 and possible association with acute kidney injury (AKI). We aimed to investigate clinical features of elevated transaminases on admission, its association with AKI, and outcomes in patients with COVID-19.

Methods:A retrospective analysis of the registered data of hospitalized patients with laboratory-confirmed COVID-19 and assessment of the AST and ALT was performed. Multinomial logistic regression was used to determine factors associated with community-acquired AKI (CA-AKI) and hospital-acquired AKI (HA-AKI).

Results:The subjects comprised 828 patients (mean age = 65.0±16.0 years; 51.4% male). Hypertension was present in 70.3% of patients, diabetes mellitus in 26.0%, and chronic kidney disease in 8.5%. In-hospital mortality was 21.0%. At admission, only 41.5% of patients had hypertransaminasemia. Patients with elevated transaminases at admission were younger, had higher levels of inflammatory markers and D-dimer, and poorer outcomes. The AKI incidence in the study population was 27.1%. Patients with hypertransaminasemia were more likely to develop AKI (33.5% vs. 23.3%, p = 0.003). Patients with predominantly elevated AST (compared to elevated ALT) were more likely to have adverse outcomes. Multinomial logistic regression found that hypertension, chronic kidney disease, elevated AST, and hematuria were associated with CA-AKI. Meanwhile, age > 65 years, hypertension, malignancy, elevated AST, and hematuria were predictors of HA-AKI.

Conclusions:Elevated transaminases on admission were associated with AKI and poor outcomes. Patients with elevated AST were more likely to have adverse outcomes. Elevated AST on admission was associated with CA-AKI and was a predictor of HA-AKI.

Type

Article

PubMed ID

36458236