S1088 Impact of Liver Injury in COVID-19 Patients: Single Center Retrospective Cohort Study

INTRODUCTION: Patients with COVID-19 infection may be at risk for liver injury, but the mechanism, and clinical significance of injury remains unclear Proposed mechanisms include direct virus-induced insults, immune-mediated damage (due to excessive inflammatory response), and drug-induced injury This study evaluates the impact of liver insults on the hospital outcome of COVID-19 patients admitted to a suburban New York safety-net hospital METHODS: In our retrospective unmatched single-center study, we identified the first 639 confirmed COVID-19 patients (age≥18 years) who were admitted to our facility from March 2020 to May 2020 Elevated liver-related enzymes (ALT >40 U/L, AST >40 U/L, or ALP >120) were used to stratify patients with or without liver injury The primary outcome was all-cause inhospital mortality;other in-patient outcomes including cardiac arrest, ARDS, arrhythmia, shock, and intubation rate were measured Chi-square tests and independent T-sample tests were used to analyze categorical and continuous variables, respectively Multivariate logistic regression analyses were performed to measure the odds of in-patient mortality and other outcomes All statistical analyses were performed using SPSS RESULTS: Out of the total 639 COVID-19 patients, 476 (74 5%) [Mean age 58 89615 61, 63 0% male] had evidence of liver injury COVID-19 liver injury cohorts had statistically significant higher rates of all cause in-patient mortality (35 5% vs 22 7%;OR 2 84;95% CI 1 71-4 71 P-value=0 003) COVID-19 liver injury was observed more often in our Hispanic patient population (38 2%) Other meaningful inpatient outcomes such as cardiac arrest (26 1% vs 14 1%;OR 2 65;95% CI 1 52-4 59, P-value=0 002), requirement of intubation (30% vs 14 7%;OR2 87;95% CI 1 70-4 85;P-value,0 001), ARDS (43 1% vs 30 7%;OR 1 89;95% CI 1 23-2 91;P-value=0 005), arrhythmia (5 2% vs 0 6%;OR 3 16;95% CI 0 95-10 33;P-value50 035) and shock (15% vs 2 8%;OR2 06;95% CI 1 15-3 70;P-value50 009) were observed more commonly in COVID-19 patients with evidence of liver injury CONCLUSION: COVID-19 patients with liver injury demonstrated nearly a three times higher risk of in-patient mortality and other poor hospitalization outcomes Hispanic patients appeared particularly vulnerable to liver injury and poor outcome