Table 1.
Demographics, clinical characteristics, laboratory parameters, and computed tomography imaging features of 440 patients with coronavirus disease 2019, stratified by severity of cumulative liver abnormality or injury
|
|
All patients (n = 440)
|
Normal cumulative LB (n = 186)
|
Cumulative LBA (n = 185)
|
Cumulative ALI (n = 69)
|
Cumulative LBAI (n = 254)
|
OR (95%CI)1
|
P
value2
|
| Characteristics | |||||||
| Age, yr, median (IQR) | 63 (25) | 61 (18) | 63 (23) | 65 (17) | 64 (18) | 2.536 | 0.012 |
| < 50 | 65 (14.8) | 33 (50.8) | 23 (35.4) | 9 (13.8) | 32 (49.2) | Ref | Ref |
| 50-64 | 203 (46.1) | 91 (44.8) | 85 (41.9) | 27 (13.3) | 112 (55.2) | 1.27 (0.73 to 2.22) | 0.404 |
| ≥ 65 | 172 (39.1) | 62 (36.0) | 77 (44.8) | 33 (19.2) | 110 (64.0) | 1.83 (1.03 to 3.26) | 0.040 |
| Sex, female | 233 (53.0) | 79 (33.9) | 109 (46.8) | 45 (19.3) | 154 (66.1) | 2.09 (1.42 to 3.06) | < 0.0001 |
| BMI, ≥ 24 kg/m2 | 124 (49.8) | 63 (50.8) | 45 (36.3) | 16 (12.9) | 61 (49.2) | 0.95 (0.58 to 1.57) | 0.849 |
| Epidemiological exposure3 | 268 (60.9) | 123 (45.9) | 104 (38.8) | 41 (15.3) | 145 (54.1) | 0.68 (0.46 to 1.01) | 0.055 |
| Smoking history | 62 (20.9) | 21 (33.9) | 31 (50.0) | 10 (16.1) | 41 (61.1) | 1.48 (0.84 to 2.61) | 0.176 |
| Comorbidities4 | 285 (64.8) | 109 (38.2) | 123 (43.2) | 53 (18.6) | 176 (61.8) | 1.59 (1.07 to 2.37) | 0.021 |
| Hypertension | 181 (41.1) | 69 (38.1) | 83 (45.9) | 29 (16.0) | 112 (61.9) | 1.34 (0.91 to 1.97) | 0.141 |
| Diabetes | 136 (30.9) | 48 (35.3) | 53 (39.0) | 35 (25.7) | 88 (64.7) | 1.52 (1.00 to 2.31) | 0.048 |
| Cardiovascular disease | 56 (12.7) | 22 (39.3) | 19 (33.9) | 15 (26.8) | 34 (60.7) | 1.15 (0.65 to 2.04) | 0.628 |
| Cerebrovascular disease | 16 (3.6) | 4 (25.0) | 8 (50.0) | 4 (25.0) | 12 (75.0) | 2.26 (0.72 to 7.11) | 0.165 |
| Chronic renal disease | 21 (4.8) | 11 (52.4) | 9 (42.9) | 1 (4.8) | 10 (47.6) | 0.65 (0.27 to 1.57) | 0.340 |
| Chronic liver disease | 12 (2.7) | 4 (33.3) | 7 (58.3) | 1 (8.3) | 8 (66.7) | 1.48 (0.44 to 4.99) | 0.527 |
| Chronic hepatitis B | 8 (1.8) | 2 (25.0) | 5 (62.5) | 1 (12.5) | 6 (75.0) | 2.23 (0.44 to 11.15) | 0.331 |
| Other chronic liver disease5 | 4 (0.9) | 2 (50.0) | 2 (50.0) | 0 | 2 (50.0) | 0.73 (0.10 to 5.23) | 0.754 |
| Chronic respiratory disease | 31 (7.0) | 16 (51.6) | 9 (29.0) | 6 (19.4) | 15 (48.4) | 0.67 (0.32 to 1.39) | 0.278 |
| Signs and symptoms at disease onset | |||||||
| Fever (temperature ≥ 37.3 °C) | 369 (85.8) | 149 (40.4) | 159 (43.1) | 61 (16.5) | 220 (59.6) | 1.63 (0.95 to 2.81) | 0.079 |
| Sputum | 236 (53.6) | 93 (39.4) | 104 (44.1) | 39 (16.5) | 143 (60.6) | 1.29 (0.88 to 1.88) | 0.191 |
| Dyspnoea | 243 (55.2) | 82 (33.7) | 116 (47.7) | 45 (18.5) | 161 (66.3) | 2.2 (1.49 to 3.23) | < 0.0001 |
| Haemoptysis | 63 (14.3) | 25 (39.7) | 26 (41.3) | 12 (19.0) | 38 (60.3) | 1.13 (0.66 to 1.95) | 0.653 |
| Chest pain/tightness | 227 (51.6) | 88 (38.8) | 100 (44.1) | 39 (17.2) | 139 (61.2) | 1.35 (0.92 to 1.97) | 0.125 |
| Pharyngalgia/nasal congestion/running | 94 (21.4) | 47 (50.0) | 33 (35.1) | 14 (14.9) | 47 (50.0) | 0.67 (0.42 to 1.06) | 0.088 |
| Headaches/dizziness | 135 (30.7) | 57 (42.2) | 54 (40.0) | 24 (17.8) | 78 (57.8) | 1.00 (0.67 to 1.51) | 0.989 |
| Myalgia/fatigue | 289 (65.7) | 122 (42.2) | 120 (41.5) | 47 (16.3) | 167 (57.8) | 1.01 (0.68 to 1.50) | 0.973 |
| Nausea/vomiting | 133 (30.2) | 53 (39.8) | 59 (44.4) | 21 (15.8) | 80 (60.2) | 1.15 (0.76 to 1.75) | 0.498 |
| Abdominal pain | 70 (15.9) | 29 (41.4) | 26 (37.1) | 15 (21.4) | 41 (58.6) | 1.04 (0.62 to 1.75) | 0.876 |
| Diarrhea | 185 (42.0) | 78 (42.2) | 83 (44.9) | 24 (13.0) | 107 (57.8) | 1.01 (0.69 to 1.48) | 0.968 |
| On-admission vital signs | |||||||
| Temperature, ≥ 37.3 °C | 103 (23.8) | 26 (25.2) | 50 (48.5) | 27 (26.2) | 77 (74.8) | 2.74 (1.67 to 4.49) | < 0.0001 |
| Respiratory rate, ≥ 30 breaths per min | 53 (12.1) | 13 (24.5) | 21 (39.6) | 19 (35.8) | 40 (75.5) | 2.50 (1.30 to 4.82) | 0.006 |
| Pulse oximeter O2 saturation, ≤ 93% | 146 (35.0) | 25 (17.1) | 82 (56.2) | 39 (26.7) | 121 (82.9) | 6.37 (3.89 to 10.43) | < 0.0001 |
| Systolic blood pressure, < 90 mmHg | 4 (0.9) | 2 (50.0) | 2 (50.0) | 0 | 2 (50.0) | 0.74 (0.10 to 5.27) | 0.760 |
| Heart rate, > 125 beats per min | 23 (5.2) | 5 (21.7) | 10 (43.5) | 8 (34.8) | 18 (78.3) | 2.77 (1.01 to 7.61) | 0.048 |
| Severity of illness | |||||||
| In-hospital disease severity status, general | 128 (29.1) | 88 (68.8) | 37 (28.9) | 3 (2.3) | 40 (31.3) | Ref | Ref |
| Severe | 184 (41.8) | 80 (43.5) | 84 (45.7) | 20 (10.9) | 104 (56.5) | 2.86 (1.78 to 4.59) | < 0.0001 |
| Critical | 128 (29.1) | 18 (14.1) | 64 (50.0) | 46 (35.9) | 110 (85.9) | 13.44 (7.21 to 25.07) | < 0.0001 |
| qSOFA score, 0 | 231 (52.7) | 114 (49.4) | 95 (41.1) | 22 (9.5) | 117 (50.6) | Ref | Ref |
| 1 | 179 (40.9) | 59 (33.0) | 80 (44.7) | 40 (22.3) | 120 (67.0) | 1.98 (1.32 to 2.97) | < 0.0001 |
| 2-3 | 28 (6.4) | 13 (46.4) | 9 (32.1) | 6 (21.4) | 15 (53.6) | 1.12 (0.51 to 2.47) | 0.770 |
| CURB-65 score, 0-1 | 330 (75.3) | 159 (48.2) | 132 (40.0) | 39 (11.8) | 171 (51.8) | Ref | |
| 2 | 71 (16.2) | 17 (23.9) | 41 (57.7) | 13 (18.3) | 54 (76.1) | 2.95 (1.64 to 5.31) | < 0.0001 |
| 3-5 | 37 (8.4) | 10 (27.0) | 11 (29.7) | 16 (43.2) | 27 (73.0) | 2.51 (1.18 to 5.35) | 0.017 |
| Routine blood results | |||||||
| White blood cell count, < 3.5 × 109/L | 44 (10.0) | 17 (38.6) | 19 (43.2) | 8 (18.2) | 27 (61.4) | 0.68 (0.35 to 1.29) | 0.234 |
| 3.5-9.5 | 313 (71.3) | 151 (48.2) | 126 (40.3) | 36 (11.5) | 162 (51.8) | Ref | Ref |
| > 9.5 | 82 (18.7) | 18 (22.0) | 40 (48.8) | 24 (29.3) | 64 (78.0) | 2.24 (1.00 to 4.99) | 0.049 |
| Lymphocyte count, < 1.1 × 109/L | 232 (52.8) | 62 (26.7) | 115 (49.6) | 55 (23.7) | 170 (73.3) | 4.1 (2.74 to 6.12) | < 0.0001 |
| Neutrophil count, > 6.3 × 109/L | 149 (33.9) | 44 (29.5) | 73 (49.0) | 32 (21.5) | 105 (70.5) | 2.29 (1.50 to 3.49) | < 0.0001 |
| Hemoglobin, < 130 g/L for male; < 115 g/L for female | 194 (44.4) | 85 (43.8) | 76 (39.2) | 33 (17.0) | 109 (56.2) | 0.90 (0.61 to 1.31) | 0.576 |
| Platelet count, < 125 × 109/L | 59 (13.5) | 17 (28.8) | 31 (52.5) | 11 (18.6) | 42 (71.2) | 1.98 (1.09 to 3.6) | 0.026 |
| Biochemical results-basic values | |||||||
| Albumin, < 35 g/L | 232 (52.7) | 58 (25.0) | 118 (50.9) | 56 (24.1) | 174 (75.0) | 4.80 (3.19 to 7.22) | < 0.0001 |
| ALT, > 41 U/L for male; > 33 U/L for female | 113 (25.7) | 0 | 77 (68.1) | 36 (31.9) | 113 (100.0%) | - | - |
| AST, > 40 U/L for males; > 32 U/L for females | 144 (32.7) | 0 | 91 (63.2) | 53 (36.8) | 144 (100.0) | - | - |
| Total bilirubin, > 26 mmol/L for males; > 21 mmol/L for females | 25 (5.7) | 0 | 12 (48.0) | 13 (52.0) | 25 (100.0) | - | - |
| Direct bilirubin, > 8.0 mmol/L | 61 (13.9) | 4 (6.6) | 29 (47.5) | 28 (45.9) | 57 (93.4) | 13.16 (4.68 to 37.01) | < 0.0001 |
| Lactate dehydrogenase, > 225 U/L for males; > 214 U/L for females | 332 (75.5) | 105 (31.6) | 162 (48.8) | 65 (19.6) | 227 (68.4) | 6.49 (3.96 to 10.62) | < 0.0001 |
| γ-Glutamyl transferase, > 71 U/L for males; > 42 U/L for females | 115 (26.4) | 20 (17.4) | 62 (53.9) | 33 (28.7) | 95 (82.6) | 5.12 (3.01 to 8.7) | < 0.0001 |
| Creatinine, > 104 μmol/L for males; > 84 μmol/L for females | 70 (16.0) | 22 (31.4) | 31 (44.3) | 17 (24.3) | 48 (68.6) | 1.73 (1.01 to 2.99) | 0.048 |
| C-reactive protein, ≥ 1 mg/L | 369 (87.6) | 145 (39.3) | 161 (43.6) | 63 (17.1) | 224 (60.7) | 2.92 (1.59 to 5.36) | 0.0010 |
| Coagulation and inflammation index results | |||||||
| Prothrombin time, ≤ 14.5 s | 289 (66.3) | 144 (49.8) | 116 (40.1) | 29 (10.0) | 145 (50.2) | 0.35 (0.23 to 0.54) | < 0.0001 |
| Prothrombin activity, < 75% | 82 (18.8) | 14 (17.1) | 43 (52.4) | 25 (30.5) | 68 (82.9) | 4.39 (2.38 to 8.09) | < 0.0001 |
| Activated partial thromboplastin time, > 42.0 s | 166 (38.2) | 46 (27.7) | 89 (53.6) | 31 (18.7) | 120 (72.3) | 2.69 (1.77 to 4.07) | < 0.0001 |
| D-dimer, > 0.5 μg/mL | 295 (68.4) | 87 (29.5) | 145 (49.2) | 63 (21.4) | 208 (70.5) | 5.17 (3.33 to 8.03) | < 0.0001 |
| Serum ferritin, > 400 μg/L for males; > 150 μg/L for females | 319 (81.0) | 111 (34.8) | 153 (48.0) | 55 (17.2) | 208 (65.2) | 6.91 (3.80 to 12.57) | < 0.0001 |
| Interleukin-6, ≥ 7 pg/mL | 255 (62.3) | 73 (28.6) | 123 (48.2) | 59 (23.1) | 182 (71.4) | 4.62 (3.01 to 7.08) | < 0.0001 |
| Interleukin-10, ≥ 5 pg/mL | 177 (44.1) | 41 (23.2) | 90 (50.8) | 46 (26.0) | 136 (76.8) | 4.67 (3.01 to 7.25) | < 0.0001 |
| Procalcitonin, ≥ 0.5 ng/mL | 57 (13.6) | 10 (17.5) | 29 (50.9) | 18 (31.6) | 47 (82.5) | 3.76 (1.84 to 7.68) | < 0.0001 |
| Imaging features | |||||||
| Bilateral | 381 (93.2) | 155 (40.7) | 162 (42.5) | 64 (16.8) | 226 (59.3) | 2.62 (1.18 to 5.84) | 0.018 |
| Ground-glass opacity | 306 (74.8) | 119 (38.9) | 131 (42.8) | 56 (18.3) | 187 (61.1) | 1.73 (1.10 to 2.72) | 0.017 |
| Consolidation | 89 (21.8) | 29 (32.6) | 36 (40.4) | 24 (27.0) | 60 (67.4) | 1.69 (1.03 to 2.78) | 0.037 |
| Pleural effusion | 47 (11.5) | 6 (12.8) | 25 (53.2) | 16 (34.0) | 41 (87.2) | 5.85 (2.42 to 14.13) | < 0.0001 |
Data are presented as medians (interquartile range) or n (%) according to the corresponding conditions.
1
ORs were calculated using univariate unconditional logistic regression.
2
All P values were calculated using univariate unconditional logistic regression for the characteristics between the patients with normal cumulative liver biochemistry and those with cumulative liver biochemical abnormality or injury, but two independent samples (unpaired) Student's t-test was used to compare the median ages.
3
Referring to exposure to confirmed coronavirus disease 2019 patients.
4
Comorbidities were defined as history of at least one disease out of the following: Hypertension, diabetes, cardiovascular disease, cerebrovascular disease, chronic renal disease, chronic respiratory disease, and chronic liver disease.
5
Four patients reported history of either fatty liver or cirrhosis. “-“: It is not applicable due to the no individuals with abnormal alanine aminotransferase or aspartate aminotransferase or total bilirubin in normal cumulative liver biochemistry group. COVID-19: Coronavirus disease 2019; LB: Liver biochemistry; LBA: Liver biochemical abnormality; ALI: Acute liver injury; LBAI: Liver biochemical abnormality or injury; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; CURB-65: Confusion, uremia, respiratory rate, blood pressure, and age ≥ 65; IQR: Interquartile range; OR: Odds ratio; CI: Confidence interval; qSOFA: Quick Sequential Organ Failure Assessment; BMI: Body mass index.