5 – 8 The main symptoms and signs of COVID-19 patients include fever, accompanied by dry cough, dyspnea, diarrhea, fatigue, and lymphopenia. Moreover, conjunctiva, cardiomyocytes and renal tubular epithelial cells have also been identified as functional receptors for SARS-CoV-2. 4 Recently, angiotensin-converting enzyme 2 (ACE2), expressed mainly in pulmonary epithelial cells and upper respiratory tract epithelium cells, was identified as a receptor of the virus. However, the transmission infectivity through feces may be less. The duration of viral shedding from the feces after negative conversion in pharyngeal swabs was 7 (6‐10) days, regardless of COVID‐19 severity. 3 Recent studies have shown that the virus is also present in stool. The study has found SARS-CoV-2 mainly causes infection in humans through droplets or direct contact. 2 As of 31 March, 2020, a total of 700,000 people had been infected with SARS-CoV-2 and more than 33,000 patients had died from COVID-19 all over the world. COVID-19 has since become a worldwide pandemic. SARS-CoV-2-induced disease was named as coronavirus disease 2019 (COVID-19) by the World Health Organization. 1 This novel coronavirus was named as severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) by the International Committee on Taxonomy of Viruses. In December 2019, a novel coronavirus-induced respiratory infectious disease was found in Wuhan city of central China. COVID-19-associated LD does not recover completely by 14 days after discharge. Follow-up observation found that more than one hepatic functional index of two-third patients remained abnormal at 14 days after discharge.Ĭonclusions: LD at early disease stage elevates the risk of death of COVID-19 patients. Moreover, the fatality rate was higher in patients with cholestasis than those without cholestasis (relative risk=2.182, p<0.05). Risk of death analysis showed that the fatality rate was higher in patients with hypoproteinemia than in those without hypoproteinemia (relative risk=9.471, p<0.01). By multivariate logistic regression, male sex, older age and lymphopenia were three important independent risk factors predicting LD among COVID-19 patients. As expected, LD was more common in critically ill patients. On admission, 223 (62.8%) patients presented with hypoproteinemia, 151(42.5%) with cholestasis, and 101 (28.5%) with hepatocellular injury. Results: Of the 355 COVID-19 patients, 211 had mild disease, 88 had severe disease, and 51 had critically ill disease. The association between LD and the risk of death was analyzed. LD was evaluated and its prognosis was tracked. Clinical data were collected from electronic medical records. Methods: Three-hundred and fifty-five COVID-19 patients were recruited. The aim of this study was to analyze COVID-19-associated liver dysfunction (LD), its association with the risk of death and prognosis after discharge. Background and Aims: Coronavirus disease 2019 (COVID-19) is a new respiratory infectious disease caused by severe acute respiratory syndrome coronavirus-2 (commonly known as SARS-CoV-2) with multiple organ injuries.
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