TABLE 2.
Liver Injury During COVID‐19 in LT Recipients
| Variable | Covariate | All Patients (n = 81) | ALT <2× ULN (n = 53; 65.4%) | ALT 2‐5× ULN (n = 18; 22.2%) | ALT >5× ULN (n = 10, 12.3%) | P Value |
|---|---|---|---|---|---|---|
| Age, years | Median (IQR) | 63 (14) | 65.0 (13) | 57.5 (23) | 62.0 (11) | 0.406 |
| Sex | Male | 38 (46.9%) | 29 (54.7) | 8 (44.4) | 5 (50.0) | 0.747 |
| Female | 42 (51.9%) | 24 (45.3) | 10 (55.6) | 5 (50.0) | ||
| Race/ethnicity | NH White | 39 (48.1%) | 18 (34.0) | 2 (11.0) | 1 (10.0) | 0.038 |
| NH Black | 21 (25.9%) | 15 (28.3) | 6 (33.3) | 1 (10.0) | ||
| NH Asian | 22 (27.2%) | 3 (5.7) | 1 (5.6) | 0 (0) | ||
| Hispanic or Latino | 33 (40.7%) | 17 (32.1) | 9 (50.0) | 7 (70.0) | ||
| Comorbidities | DM | 38 (46.9%) | 20 (37.7) | 12 (66.7) | 6 (60.0) | 0.071 |
| HTN | 46 (56.8%) | 26 (49.1) | 11 (61.1) | 9 (90.0) | 0.050 | |
| Hyperlipidemia | 20 (24.7%) | 9 (17.0) | 7 (38.9) | 4 (40.0) | 0.086 | |
| Obesity | 21 (25.9%) | 11 (20.8) | 6 (33.3) | 4 (40.0) | 0.319 | |
| Metabolic syndrome | 17 (21.0%) | 7 (13.2) | 6 (33.3) | 4 (40.0) | 0.056 | |
| Coronary artery disease | 9 (11.1%) | 5 (9.4) | 1 (5.6) | 3 (30.0) | 0.115 | |
| Severity of COVID‐19 | Hospitalization | 71 (87.7%) | 44 (83.0) | 17 (94.4) | 10 (100.0) | 0.199 |
| ICU admission | 28 (34.6%) | 12 (22.6) | 7 (38.9) | 9 (90.0) | 0.002 | |
| Mechanical ventilation | 24 (29.6%) | 9 (17.0) | 6 (33.3) | 9 (90.0) | <0.001 | |
| Vasopressor use | 23 (28.4%) | 9 (17.0) | 5 (27.8) | 9 (90.0) | <0.001 | |
| Supplemental oxygen | 54 (66.7%) | 33 (62.3) | 11 (61.1) | 10 (100.0) | 0.057 | |
| Death | 25 (30.9%) | 10 (18.6) | 6 (33.3) | 8 (80.0) | 0.003 | |
| Hepatotoxic medication | Yes | 65 (80.2%) | 40 (75.4) | 16 (88.8) | 9 (90.0) | 0.331 |
| Any antibiotics | 60 (74.1%) | 34 (64.15) | 16 (88.8) | 10 (100.0) | 0.016 | |
| Cephalosporin | 40 (49.4%) | 21 (40.4) | 10 (55.6) | 9 (90.0) | 0.012 | |
| APAP | 29 (35.8%) | 16 (49.1) | 8 (44.4) | 5 (50.0) | 0.335 | |
| Statins | 16 (19.8%) | 9 (17.0) | 4 (22.2) | 3 (30.0) | 0.610 | |
| PPI | 33 (40.7%) | 21 (39.6) | 8 (44.4) | 4 (40.0) | 0.936 | |
| COVID‐19 treatment | Hydroxychloroquine + azithromycin | 23 (28.4%) | 13 (24.5) | 6 (33.3) | 4 (40.0) | 0.246 |
| Hydroxychloroquine | 16 (19.8%) | 8 (15.1) | 5 (27.8) | 3 (30.0) | 0.347 | |
| Immunosuppression | Tacrolimus | 73 (90.1%) | 46 (86.7) | 17 (94.4) | 10 (100.0) | 0.344 |
| Cyclosporine | 6 (7.4%) | 6 (11.3) | 0 (0) | 0 (0) | 0.181 | |
| MMF | 41 (50.6%) | 28 (52.8) | 6 (33.3) | 7 (70.0) | 0.153 | |
| Prednisone, low dose | 22 (27.2%) | 14 (45.3) | 4 (18.2) | 4 (40.0) | 0.586 | |
| Change in immunosuppression | Decreased tacrolimus | 21 (25.9%) | 12 (22.6) | 4 (22.2) | 5 (50.0) | 0.735 |
| Held MMF | 27 (33.3%) | 18 (34.0) | 4 (22.2) | 5 (50.0) | 0.617 | |
| Labs (peak COVID‐19) | Creatinine | 1.9 (2.3) | 1.6 (2.3) | 1.8 (1.7) | 4.1 (2.3) | 0.026 |
| WBC | 5.3 (4.6) | 5.0 (3.8) | 5.5 (7.4) | 14.1 (20.6) | 0.237 | |
| Neutrophil | 3.4 (4.1) | 3.3 (3.8) | 4.2 (5.0) | 2.7 (10.5) | 0.792 | |
| Lymphocyte | 0.8 (0.7) | 0.8 (0.6) | 0.9 (1.4) | 0.6 (2.1) | 0.145 |
Bold signifies statistically significant.
Abbreviations: APAP, acetaminophen; MMF, mycophenolate; NH, non‐Hispanic; WBC, white blood cell count.