Are liver abnormalities associated with hospital mortality in viral infections?

Mohammad Abu Zaid *, Mohammad Mamoun Ali Allan, Ali Fayez Mohammad AL-Bourini, Tareq Said Mohammad Alamour and Hadeel Hamad Khazer Aljboor

Internal Medicine; Internal Medicine department; Royal Medical Services, Jordan.
 
Research Article
World Journal of Biology Pharmacy and Health Sciences, 2024, 17(02), 009–021.
Article DOI: 10.30574/wjbphs.2024.17.2.0049
Publication history: 
Received on 29 January 2024; revised on 06 February 2024; accepted on 07 February  2024
 
Abstract: 
Objective: Patients hospitalised with severe viral infections may have abnormal liver function. Multiple studies have linked systemic-disseminated viral infections to liver damage. The progression, medical significance, and impact of atypical liver chemical levels on hospitalised infections are unknown.
Aims: This study addresses these concerns and examines how liver-related biochemical abnormalities affect viral infection patients' clinical outcomes.
Methods: A retrospective study was conducted at the royal medical services’ institutions, focusing on patients admitted over two years. The primary purpose was to gather information about patients who underwent testing. Patients with abnormalities in liver indices, specifically alanine transferase (ALT) and aspartate aminotransferase (AST), were included in the study. Patients with an AST/ALT ratio greater than 2 were excluded. Patients were classified as either having a lower liver disease status (Status I) or a higher liver disease status (Status II). The classification of liver disease statuses was based on the LDH to AST ratio (below 6.5 or higher than 6.5). The study used independent T-tests, Chi Square Test, and multiple logistic regression to analyze non-parametric data. A significance level of 5% was chosen, and SPSS ver 25 was used for the study. The study aimed to determine the effects of gender, severity group at admission, and composite predictors on the likelihood of admitted viral infected patients having liver diseases.
Results: MAOVA analysis revealed a significant difference in overall mortality among individuals infected with SARS-VIRAL, based on the LDH: AST 1 and LDH: AST 2 ratios. The statistical test yielded an F-value of 1204.283 with degrees of freedom (2, 778), and a p-value of less than .0005. Additionally, Wilk's Lambda was found to be 0.244, indicating a strong effect size (partial η2 = 0.756).
Conclusion: The involvement of the liver in viral infections is directly correlated with mortality, as this correlation is very clear. Therefore, it is of the utmost importance to incorporate hepatic enzymes as a criterion when evaluating patients who have viral infections. This is because of the impact that elevated liver enzymes have on immune cells and, as a result, the overall clinical outcomes. Since this is the case, it is essential for viral patients to undergo daily monitoring of their liver enzymes on a consistent basis.
 
Keywords: 
Liver abnormalities; Viral infections; Hospitalized patients; Child-Pugh score
 
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