Pattern and Risk Factors of Liver Injury among Hospitalized Covid-19 Patients:The Experience of a Greek Referral Hospital

Background:Although the new coronavirus(SARS-COV-2)affects predominantly the respiratory system,concomitant liver manifestations are common among COVID-19 patients.Aim:To investigate the prevalence and pattern of liver impairment(hepatocellular,cholestatic,mixed)and identify risk factors potentially associated with the liver injury in hospitalized patients with Covid-19.Materials and Methods:This retrospective study enrolled consecutive patients with Covid-19 who had evidence of liver injury on admission and/or during hospitalization in a tertiary hospital.Patient demographic,clinical and laboratory data were captured from the hospital’s electronic data monitoring system.Univariate and multivariate logistic regression analysis were applied to identify risk factors for liver injury.Results:Overall,of the 113 hospitalized Covid-19 patients,73(64.6%)patients had evidence of liver injury.Admission to Intensive Care Unit and length of in-hospital stay were identified as independent risk factors for liver injury by multivariate analysis(p=0.014 and p=0.001,respectively).35 patients(47.9%)had hepatocellular and 18 patients(24.7%)had cholestatic liver injury.Admission to Intensive Care Unit was statistically significantly associated with hepatocellular injury(p=0.006).Conclusions:Liver injury is common in hospitalized Covid-19 patients.Hepatocellular-type injury is more common and is associated with a more severe course of disease.