Systematic review with meta‐analysis: liver manifestations and outcomes in COVID‐19

Anand V. Kulkarni; Pramod Kumar; Harsh Vardhan Tevethia; Madhumita Premkumar; Juan Pablo Arab; Roberto Candia; Rupjyoti Talukdar; Mithun Sharma; Xiaolong Qi; Padaki Nagaraja Rao; Duvvuru Nageshwar Reddy

doi:10.1111/apt.15916

journal article Jul 08, 2020

Systematic review with meta‐analysis: liver manifestations and outcomes in COVID‐19

Anand V. Kulkarni

Pramod Kumar

Harsh Vardhan Tevethia Madhumita Premkumar

Juan Pablo Arab

Roberto Candia Rupjyoti Talukdar

Mithun Sharma Xiaolong Qi

Padaki Nagaraja Rao Duvvuru Nageshwar Reddy

Alimentary Pharmacology & Therapeutics Vol. 52 No. 4 pp. 584-599 · Wiley

View at Publisher Save 10.1111/apt.15916

Abstract

SummaryBackgroundThe incidence of elevated liver chemistries and the presence of pre‐existing chronic liver disease (CLD) have been variably reported in COVID‐19.AimsTo assess the prevalence of CLD, the incidence of elevated liver chemistries and the outcomes of patients with and without underlying CLD/elevated liver chemistries in COVID‐19.MethodsA comprehensive search of electronic databases from 1 December 2019 to 24 April 2020 was done. We included studies reporting underlying CLD or elevated liver chemistries and patient outcomes in COVID‐19.Results107 articles (n = 20 874 patients) were included for the systematic review. The pooled prevalence of underlying CLD was 3.6% (95% CI, 2.5‐5.1) among the 15 407 COVID‐19 patients. The pooled incidence of elevated liver chemistries in COVID‐19 was 23.1% (19.3‐27.3) at initial presentation. Additionally, 24.4% (13.5‐40) developed elevated liver chemistries during the illness. The pooled incidence of drug‐induced liver injury was 25.4% (14.2‐41.4). The pooled prevalence of CLD among 1587 severely infected patients was 3.9% (3%‐5.2%). The odds of developing severe COVID‐19 in CLD patients was 0.81 (0.31‐2.09; P = 0.67) compared to non‐CLD patients. COVID‐19 patients with elevated liver chemistries had increased risk of mortality (OR‐3.46 [2.42‐4.95, P < 0.001]) and severe disease (OR‐2.87 [95% CI, 2.29‐3.6, P < 0.001]) compared to patients without elevated liver chemistries.ConclusionsElevated liver chemistries are common at presentation and during COVID‐19. The severity of elevated liver chemistries correlates with the outcome of COVID‐19. The presence of CLD does not alter the outcome of COVID‐19. Further studies are needed to analyse the outcomes of compensated and decompensated liver disease.

Topics

No keywords indexed for this article. Browse by subject →

References

141

[1]

10.1016/j.ijid.2020.03.017

[2]

10.1016/j.kint.2020.03.005

[3]

EASL Clinical Practice Guidelines for the management of patients with decompensated cirrhosis

Paolo Angeli, Mauro Bernardi, Càndid Villanueva et al.

Journal of Hepatology 10.1016/j.jhep.2018.03.024

[4]

10.1111/liv.14465

[5]

10.1016/j.jinf.2020.04.021

[6]

10.1001/jama.283.15.2008

[7]

10.1016/j.jhep.2020.04.006

[8]

10.1097/cm9.0000000000000819

[9]

Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America

Joshua P. Metlay, Grant W. Waterer, Ann C. Long et al.

American Review of Respiratory Disease 10.1164/rccm.201908-1581st

[10]

Development of a critical appraisal tool to assess the quality of cross-sectional studies (AXIS)

Martin J Downes, Marnie L Brennan, Hywel C Williams et al.

BMJ Open 10.1136/bmjopen-2016-011458

[11]

10.1016/j.jclinepi.2015.07.010

[12]

10.1136/bmj.d5928

[13]

WellsGA SheaB O'connellD et al.The Newcastle‐Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta‐analyses.2013.http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp. Accessed May 23 2020.

[14]

10.1001/jama.2020.4326

[15]

A Trial of Lopinavir–Ritonavir in Adults Hospitalized with Severe Covid-19

Bin Cao, Yeming Wang, Danning Wen et al.

New England Journal of Medicine 10.1056/nejmoa2001282

[16]

Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China

Chaolin Huang, Yeming Wang, Xingwang Li et al.

The Lancet 10.1016/s0140-6736(20)30183-5

[17]

10.1016/s1473-3099(20)30086-4

[18]

10.1093/qjmed/hcaa089

[19]

10.1016/j.ijid.2020.03.022

[20]

10.1016/s0140-6736(20)30566-3

[21]

Risk Factors Associated With Acute Respiratory Distress Syndrome and Death in Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, China

Chaomin Wu, Xiaoyan Chen, Yanping Cai et al.

JAMA Internal Medicine 10.1001/jamainternmed.2020.0994

[22]

Liu M "Clinical characteristics of 30 medical workers infected with new coronavirus pneumonia" Zhonghua Jie He He Hu Xi Za Zhi (2020)

[23]

10.1093/cid/ciaa247

[24]

Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records

Huijun Chen, Juanjuan Guo, Chen Wang et al.

The Lancet 10.1016/s0140-6736(20)30360-3

[25]

10.1007/s11427-020-1661-4

[26]

10.1183/13993003.00398-2020

[27]

Clinical Characteristics of Coronavirus Disease 2019 in China

Wei-jie Guan, Zheng-yi Ni, Yu Hu et al.

New England Journal of Medicine 10.1056/nejmoa2002032

[28]

10.1016/j.jinf.2020.02.016

[29]

Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study

Nanshan Chen, Min Zhou, Xuan Dong et al.

The Lancet 10.1016/s0140-6736(20)30211-7

[30]

10.1007/s11427-020-1643-8

[31]

10.1016/j.tmaid.2020.101606

[32]

10.1093/cid/ciaa199

[33]

10.1136/bmj.m606

[34]

10.1093/cid/ciaa538

[35]

10.1016/s2213-2600(20)30079-5

[36]

Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China

Dawei Wang, Bo Hu, Chang Hu et al.

JAMA 10.1001/jama.2020.1585

[37]

A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster

Jasper Fuk-Woo Chan, Shuofeng Yuan, Kin-Hang Kok et al.

The Lancet 10.1016/s0140-6736(20)30154-9

[38]

10.1016/j.ijid.2020.03.013

[39]

10.1093/cid/ciaa270

[40]

10.1016/j.jinf.2020.03.004

[41]

10.1111/all.14238

[42]

10.1002/jmv.25763

[43]

10.1186/s13054-020-2833-7

[44]

Clinical Outcomes in 55 Patients With Severe Acute Respiratory Syndrome Coronavirus 2 Who Were Asymptomatic at Hospital Admission in Shenzhen, China

Yanrong Wang, Yingxia Liu, Lei Liu et al.

The Journal of Infectious Diseases 10.1093/infdis/jiaa119

[45]

10.5582/bst.2020.01030

[46]

10.1002/jmv.25810

[47]

10.1016/s1473-3099(20)30176-6

[48]

10.1002/jmv.25891

[49]

10.2147/clep.s249903

[50]

Zheng F "Clinical characteristics of 161 cases of corona virus disease 2019 (COVID‐19) in Changsha" Eur Rev Med Pharmacol Sci (2020)

Showing 50 of 141 references

Cited By

207

COVID-19 and the liver: A brief and core review

Bircan Kayaaslan, Rahmet Guner · 2021

World Journal of Hepatology

Hepatic Steatosis Is Associated with Increased Disease Severity and Liver Injury in Coronavirus Disease-19

Vincent L. Chen, Fadi Hawa · 2020

Digestive Diseases and Sciences

Metrics

207

Citations

141

References

Details

Published: Jul 08, 2020
Vol/Issue: 52(4)
Pages: 584-599
License: View

Authors

A

Anand V. Kulkarni

Department of Hepatology Asian Institute of Gastroenterology Hyderabad India

P

Pramod Kumar

Department of Hepatology Asian Institute of Gastroenterology Hyderabad India

H

Harsh Vardhan Tevethia

Department of Gastroenterology Asian Institute of Gastroenterology Hyderabad India

M

Madhumita Premkumar

Department of Hepatology PGIMER Chandigarh India

J

Juan Pablo Arab

Departamento de Gastroenterologia Escuela de Medicina Pontificia Universidad Catolica de Chile Santiago Chile

R

Roberto Candia

Departamento de Gastroenterologia Escuela de Medicina Pontificia Universidad Catolica de Chile Santiago Chile

R

Rupjyoti Talukdar

Department of Gastroenterology Asian Institute of Gastroenterology Hyderabad India

M

Mithun Sharma

Department of Hepatology Asian Institute of Gastroenterology Hyderabad India

X

Xiaolong Qi

CHESS Center Institute of Portal Hypertension The First Hospital of Lanzhou University Lanzhou China

P

Padaki Nagaraja Rao

Department of Hepatology Asian Institute of Gastroenterology Hyderabad India

D

Duvvuru Nageshwar Reddy

Department of Gastroenterology Asian Institute of Gastroenterology Hyderabad India

Cite This Article

Anand V. Kulkarni, Pramod Kumar, Harsh Vardhan Tevethia, et al. (2020). Systematic review with meta‐analysis: liver manifestations and outcomes in COVID‐19. Alimentary Pharmacology & Therapeutics, 52(4), 584-599. https://doi.org/10.1111/apt.15916

Systematic review with meta‐analysis: liver manifestations and outcomes in COVID‐19

You May Also Like