الملخص الإنجليزي
Objectives: Initial reports indicate a high incidence of abnormal aspartate aminotransferase
(AST) and alanine aminotransferase (ALT) levels in patients with COVID-19 and
possible association with acute kidney injury (AKI). We aimed to investigate clinical
features of elevated transaminases on admission, its association with AKI, and outcomes
in patients with COVID-19. Methods: A retrospective analysis of the registered data
of hospitalized patients with laboratory-confirmed COVID-19 and assessment of the
AST and ALT was performed. Multinomial logistic regression was used to determine
factors associated with community-acquired AKI (CA-AKI) and hospital-acquired AKI
(HA-AKI). Results: The subjects comprised 828 patients (mean age = 65.0±16.0 years;
51.4% male). Hypertension was present in 70.3% of patients, diabetes mellitus in 26.0%,
and chronic kidney disease in 8.5%. In-hospital mortality was 21.0%. At admission, only
41.5% of patients had hypertransaminasemia. Patients with elevated transaminases at
admission were younger, had higher levels of inflammatory markers and D-dimer, and
poorer outcomes. The AKI incidence in the study population was 27.1%. Patients with
hypertransaminasemia were more likely to develop AKI (33.5% vs. 23.3%, p = 0.003).
Patients with predominantly elevated AST (compared to elevated ALT) were more likely
to have adverse outcomes. Multinomial logistic regression found that hypertension,
chronic kidney disease, elevated AST, and hematuria were associated with CA-AKI.
Meanwhile, age > 65 years, hypertension, malignancy, elevated AST, and hematuria
were predictors of HA-AKI. Conclusions: Elevated transaminases on admission were
associated with AKI and poor outcomes. Patients with elevated AST were more likely to
have adverse outcomes. Elevated AST on admission was associated with CA-AKI and
was a predictor of HA-AKI.
