Table 1.
Baseline Characteristics and Outcomes of Unvaccinated and Vaccinated Patients Developing COVID-19-Induced Cholestasis.
| Variables | Unvaccinated (n = 8) | Vaccinated (n = 7) | P value |
|---|---|---|---|
| Age | 59 (24–67) | 52 (29–67) | 0.38 |
| Male | 8 (100%) | 5 (71.43%) | 0.2 |
| Comorbidities (n) | 0.33 | ||
| Diabetes mellitus | 5 | 4 | |
| Hypertension | 1 | 2 | |
| Hypothyroidism | 0 | 1 | |
| CAD | 1 | 0 | |
| None | 3 | 3 | |
| Fatty liver (in a prior ultrasonography) | 2 | 4 | 0.23 |
| Symptoms of COVID-19 | |||
| Fever | 7 | 7 | 0.53 |
| Cough | 5 | 2 | 0.21 |
| Fatigue | 4 | 3 | 0.6 |
| Dyspnea | 4 | 3 | 0.6 |
| Treatment received | |||
| Remdesivir | 8 (100%) | 6 (85.7%) | 0.67 |
| Antibiotics | 8 (100%) | 7 (100%) | – |
| Steroids | 8 (100%) | 6 (85.7%) | 0.67 |
| Vasopressor therapy | 1 (12.5%) | 0 | 0.53 |
| ICU care (n, %) | 7 (87.5%) | 4 (57.1%) | 0.23 |
| MV (n, %) | 3 (37.5%) | 1 (14.3%) | 0.56 |
| NIV (n,%) | 4 (50%) | 5 (71.43%) | 0.6 |
| Time from vaccination to infection (days) | – | 23 (14–34) | |
| Number of readmissions | 1.5 (0–3) | 1 (0–2) | 0.09 |
| Duration of hospitalization for COVID-19 (days) | 24 (17–124) | 12 (7–17) | 0.11 |
| Time to rise in ALP, GGT, and bilirubin after PCR positivity (days) | 39.5 (27–57) | 35 (19–44) | 0.15 |
| Duration of readmission (days) | 38 (21–124) | 9.5 (8–12) | 0.04 |
| Baseline TB (mg/dl) | 0.85 (0.7–1.6) | 1.2 (0.9–1.5) | 0.33 |
| Baseline AST (U/L) | 33.5 (23–54) | 36 (23–56) | 0.54 |
| Baseline ALT (U/L) | 39 (23–44) | 32 (20–55) | 0.62 |
| Baseline ALP (U/L) | 99.5 (87–132) | 114 (67–154) | 0.63 |
| Baseline GGT (U/L) | 34 (12–87) | 45 (33–88) | 0.36 |
| Baseline serum creatinine¶ | 0.96 ± 0.33 | 1.01 ± 0.25 | 0.78 |
| First TB (mg/dl) | 8.35 (3.3–26.1) | 12.4 (3.1–32.4) | 0.29 |
| First AST (U/L) | 117 (21–452) | 170 (33–1256) | 0.39 |
| First ALT (U/L) | 117 (35–896) | 106 (19–627) | 0.71 |
| First ALP (U/L) | 323 (217–383) | 312 (177–489) | 0.85 |
| First GGT (U/L) | 300.5 (230–570) | 312 (71–532) | 0.59 |
| Peak TB (mg/dl) | 22.95 (4.2–48.5) | 17 (8.3–32.4) | 0.23 |
| Peak AST (U/L) | 306 (83–757) | 199 (89–1256) | 0.71 |
| Peak ALT (U/L) | 250 (111–2190) | 134 (67–627) | 0.32 |
| Peak ALP (U/L) | 571.5 (368–1058) | 312 (239–517) | 0.02 |
| Peak GGT (U/L) | 832 (491–1640) | 325 (237–600) | 0.004 |
| Lowest albumin¶ (g/dl) | 2.83 ± 0.28 | 3.25 ± 0.32 | 0.02 |
| First INR¶ | 1.19 ± 0.21 | 1.4 ± 0.24 | 0.1 |
| Peak INR¶ | 1.62 ± 0.25 | 1.7 ± 0.22 | 0.6 |
Continuous data are expressed as median (minimum–maximum) except that marked ¶ which are expressed as mean ± standard deviation.
COVID-19, coronavirus disease-2019; CAD, coronary artery disease; ICU, intensive care unit; NIV, non-invasive ventilation; IV; invasive ventilation; ALP, alkaline phosphatase; GGT, γ glutamyl transpeptidase; PCR, polymerase chain reaction; TB, total bilirubin; AST, aspartate transaminase; ALT, alanine transaminase; INR, international normalized ratio.
Baseline liver function tests are the values at diagnosis or during the index COVID-19 admission.
The first abnormal test reported to physician at the tertiary care center after COVID-19 illness (from SARS-CoV-2 positivity) are depicted here as the first TB/AST/ALT/ALP/GGT.