Search

Introduction and Objectives: Identifying independent risk factors for adverse outcomes in patients infected with severe acute respiratory syndrome coronavirus 2 can support prognostication, resource utilization, and treatment. The presenting symptoms of this virus are variable and the evolution and clinical significance of abnormal liver chemistries on outcomes in patients with coronavirus disease 2019 (COVID-19) is not well characterized. This study aimed to evaluate if aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels could predict disease severity in patients with COVID-19. Materials and Methods: a retrospective, observational and cross-sectional study was carried out with data from the medical records of patients who had positive SARS-CoV2 nasal swabs, were over 18 years of age and were admitted consecutively and under free demand at a Brazilian academic hospital from April 1 to May 31, 2021. The characteristics of liver abnormalities and outcomes of patients with COVID-19 were compared. Results: altogether, 222 patients were enrolled, three patients with cirrhosis and 82% with abnormal liver chemistries during hospitalization. Of these, 20% showed transaminases >5 times the upper limit of normal (ULN). The most prevalent liver abnormality was AST. The increase in transaminases was directly proportional to the higher rates of intensive care unit admission, longer hospital stays, higher rates of vasoactive drug use and greater pulmonary involvement in its severe forms. We found that elevations of transaminases >5 times the ULN, at any time during hospitalization were associated with increased mortality. Conclusions: coronavirus 2 hepatitis may lead to poor outcomes in patients who are hospitalized for the disease. Therefore, monitoring liver chemistries, especially AST is necessary for hospitalized patients with COVID-19.

Introduction and Objectives: Hepatopulmonary Syndrome (HPS) is a chronic and irreversible disease caused by systemic changes associated with portal hypertension, which greatly compromises patients' expectations and quality of life. It is associated with an increase in morbidity and mortality regardless of the degree of liver dysfunction. Data on the accuracy of the diagnosis of HPS in cirrhosis is limited. This study aimed to analyze the prevalence of HPS in cirrhotic patients at our service and to correlate it with oxygen saturation (SatO2) using a pulse oximeter to evaluate if this is useful as a screening test for HPS. Materials and Methods: A prospective study was conducted in consecutive patients with hepatic cirrhosis, followed up on demand and selected from November 1, 2021, to May 31, 2022. All the patients underwent an oxygen saturation measurement by pulse oximetry and arterial blood gas analysis. The relationship between SatO2 and HPS was assessed. Results: a total of 29 patients with clinically confirmed cirrhosis were analyzed, 16 (56%) male patients. Twenty-six (90%) patients had no symptoms related to HPS and 5 (17%) had arterial blood gas analysis criteria for HPS. The alcoholic etiology of cirrhosis was the most prevalent (52%). The mean age was 59 years. Twenty-two (76%) patients were classified as Child Pugh A and 7 (24%) as Child Pugh B. The relationship between HPS and SatO2 did not show statistical significance. Conclusions: Oxygen saturation alone was not able to detect HPS in the sample of cirrhotic patients. More accurate methods for screening and diagnosis of the syndrome should be used.