S0998 Correlation of Liver Enzyme Derangements and In-Hospital Outcomes of COVID-19 in a Safety Net Hospital

INTRODUCTION: COVID-19 is thought to spread from person to person via droplet transmission and direct contact routes However, there has been limited study in the United States on the patterns of different liver enzyme derangements and clinical outcomes amongst COVID-19 patients Hence, the aim of this study was to report the clinical course and liver test parameters in COVID-19 patients admitted to the hospital METHODS: This is a cross sectional study in which we reviewed the electronic medical records of patients who presented to Stroger Hospital, Chicago IL from March 15, 2020 through April 17, 2020 We classified the pattern of liver function derangement into hepatocellular, cholestatic and mixed Hepatocellular, mixed and cholestatic pattern were defined as R factor >5, 2-5 and >5 respectively Univariate and multivariate analysis were used to analyze inpatient outcomes RESULTS: Patients with abnormal liver enzymes were younger (53 1 vs 58 4), male (71 4% vs 64 9%), Hispanic (48 6% vs 42 8%) and more likely to have GI symptoms (30 5% vs 9 1%) Patients with abnormal liver enzymes were more likely to have known sick contacts (35 1% vs 25 9%), admitted from home (77 2% vs 66 2%) Patients with abnormal liver enzymes were more likely to have fever (35 5% vs 10 3%) and leukocytosis (24 7% vs 18 2%) on presentation Obesity (60 1% vs 45 4%) and hypertension (43 2% vs 37 6%) were 2 most common comorbidities in patients with abnormal liver enzymes Bilateral GGO was the most common imaging finding in patients with abnormal liver enzymes (53 6% vs 37 6%) Hepatocellular pattern was associated with hypo-albuminemia (mean 2 5, IQR 1 8-2 9, P = 0 04), elevated PTT (mean 47 5, IQR: 39-53 4, P = 0 01), higher IL-6 levels (mean 121, IQR: 115-139, P < 0 01) and elevated ferritin levels (mean 1571, IQR: 1468-1640, P < 0 01) Hepatocellular pattern was also significantly associated with elevated NLR (mean 10 6, IQR: 9 8-11 9, P < 0 01), ferritin-lymphocytic ratio (mean 2 2, IQR: 1 8-3 1, P < 0 01) The inpatient complications of COVID 19 including ICU admission (19 6% vs 16%, P = 0 006), mechanical ventilation (16 7% vs 11%, P = 0 0226), hypovolemic shock (15% vs 7 9%, P = 0 008), acute kidney injury (36 1% vs 26%, P = 0 014), renal replacement therapy and death was higher in patients with hepatocellular liver enzyme derangement CONCLUSION: Our study showed poor inpatient outcomes (ICU admission, mechanical ventilation, shock, AKI, mortality) in patients with hepatocellular enzyme derangement in patients with COVID-19