| dc.description.abstract | Coronavirus disease 2019 (covid-19) pandemic is the most recent significant global health crisis after the influenza pandemic of 1918. It has caused consequential global economic decline with loss of over 6 million lives with most of the deaths occurring in the early days of the pandemic when little was known about the virus. The disease is associated with diffuse lung injury causing acute respiratory distress syndrome which is the principal cause of death. Liver injury of variable magnitude has been documented in numerous studies. The aim of this study was to determine the association between liver biochemical profile and clinical outcome of hospitalized covid-19 patients. The specific objectives were; to determine the association between age and clinical outcome of covid-19 infection, to evaluate the association between cholestatic-hepatocellular enzymes and clinical outcome of covid-19 infection, to assess the association between serum albumin levels and clinical outcome of covid-19 infection and to determine the association between serum total bilirubin levels and clinical outcome of covid-19 infection among covid-19 patients admitted at Mount Kenya Hospital, Nyeri, Kenya. This was a retrospective cross-sectional study involving 117 covid-19 patients admitted at Mount Kenya Hospital, Nyeri. A census approach was used. Inclusion criteria was patients with positive covid-19 tested using rqRTPCR with LFTs done on admission. Exclusion criteria was patients with positive covid-19 rqRTPCR whose medical records were incomplete, patients with positive covid-19 tested using rapid antigen test, patients with comorbidities, recent history of alcohol use and pregnant women. Severity of covid-19 was based on at least one of the following: respiratory rate >/ 30 breaths/minute, oxygen saturation < 93%, mechanical ventilation, shock and need for ICU admission. Data on age, liver biochemical parameters and clinical outcome was gathered from medical records. LFT abnormalities were defined as elevation of liver enzymes in reference to Mount Kenya hospital laboratory reference range: ALT (0-42 U/L), AST (0-37 U/L), ALP (40-150 U/L), GGT (8-46U/L), TBIL (0-22 UMOL/L), DBIL (0-6.8 UMOL/L), total protein (66-87 G/L), albumin (37-57 G/L) and graded as mild liver injury (x 1-2 ULN), moderate liver injury (x 3-5 ULN) and severe liver injury (> x 5 ULN). Primary data was entered and cleaned using statistical package for social sciences version 26.0 (SPSS 26.0, 2019). Data was presented as mean ± standard deviation and frequency for normally distributed data and categorical data respectively. Statistical differences for categorical data were compared using chi-square test. Logistic regression analysis was used to assess for association between serum ALP level and clinical outcome (survival or non-survival).Statistical analysis was performed in SPSS (version 26.0, 2019) and P < 0.05 was considered statistically significant. The study established a significant association between patient’s age, serum ALP and albumin levels and clinical outcome of covid-19.Notably increasing age, high serum ALP levels and hypoalbuminemia were found to associate with clinical outcome. The study concluded that these parameters may be used for risk stratification and prognostication with prompt scaling up of clinical interventions for better health outcomes. | en_US |
