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SARS-CoV-2 proteins

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    Abnormal liver tests in admitted patients with SARS-Cov-2 or other respiratory viruses- prognostic similarities and temporal disparities

    Authors: Noa Shafran; Assaf Issachar; Tzippy Shochat; Inbal Haya Shafran; Michael Bursztyn; Amir Shlomai

    doi:10.1101/2020.10.23.20218230 Date: 2020-10-27 Source: medRxiv

    Background and Aims: Abnormal liver tests are common in patients with severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) infection MESHD, but their association with short-term outcomes is controversial. We aimed to compare the pattern of abnormal liver tests in SARS-CoV-2 patients with those of patients infected with influenza or respiratory syncytial virus MESHD ( RSV MESHD), two non-hepatotropic respiratory viruses, and their association with in-hospital mechanical ventilation or death MESHD. Methods: A retrospective cohort study of 1271 hospitalized patients (872 influenza, 218 RSV MESHD, and 181 SARS-Cov-2) in a tertiary medical center. We defined abnormal liver tests as GPT HGNC, GOT or GGT HGNC[≥]40IU/ML at any time-point during hospitalization. Results: Abnormal liver tests were mild-moderate in the majority of patients regardless of infection type but the majority of patients with influenza or RSV MESHD had a transaminases peak earlier during hospitalization compared to patients with SARS-Cov-2. Abnormal liver tests correlated with markers of severe disease across all types of infections, and were associated with mechanical ventilation or death, occurring mainly in patients with severe liver tests abnormalities (>200IU/L) (27.2%, 39.4% and 55.6% of patients with influenza, RSV MESHD or SARS-Cov-2). In multivariate analysis, controlling for age, gender, lymphopenia MESHD and CRP, liver tests abnormalities remained significantly associated with mechanical ventilation or death MESHD for influenza (OR= 3.047, 95% CI 1.518-6.117) and RSV MESHD (OR= 3.402, 95% CI 1.032- 11.220) but not for SARS-Cov-2 (OR= 0.995, 95% CI 0.198-4.989). These results were confirmed upon propensity score matching. Conclusions: Abnormal liver tests during hospitalization with different viral respiratory infections MESHD are common, may differ in their time-course and reflect disease severity. They are associated with worse outcomes, mainly in patients with severe liver test abnormalities MESHD, regardless of infection type MESHD.

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MeSH Disease
HGNC Genes
SARS-CoV-2 Proteins


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