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Article: Clinical significance of hepatic derangement in severe acute respiratory syndrome

TitleClinical significance of hepatic derangement in severe acute respiratory syndrome
Authors
Issue Date2005
PublisherBeijing Baishideng BioMed Scientific Co., Ltd. The Journal's web site is located at http://www.wjgnet.com/1007-9327/index.htm
Citation
World Journal Of Gastroenterology, 2005, v. 11 n. 14, p. 2148-2153 How to Cite?
Abstract
Aim: Elevation of alanine aminotransferase (ALT) level is commonly seen among patients suffering from severe acute respiratory syndrome (SARS). We report the progression and clinical significance of liver derangement in a large cohort of SARS patient. Methods: Serial assay of serum ALT was followed in patients who fulfilled the WHO criteria of SARS. Those with elevated ALT were compared with those with normal liver functions for clinical outcome. Serology for hepatitis B virus (HBV) infection was checked. Adverse outcomes were defined as oxygen desaturation, need of intensive care unit (ICU) and mechanical ventilation and death. Results: Two hundred and ninety-four patients were included in this study. Seventy (24%) patients had elevated serum ALT on admission and 204 (69%) patients had elevated ALT during the subsequent course of illness. Using peak ALT >5×ULN as a cut-off and after adjusting for potential confounding factors, the odds ratio of peak ALT >5× ULN for oxygen desaturation was 3.24 (95%CI 1.23-8.59, P = 0.018), ICU care was 3.70 (95%CI 1.38-9.89, P = 0.009), mechanical ventilation was 6.64 (95%CI 2.22-19.81, P = 0.001) and death was 7.34 (95%CI 2.28-24.89, P = 0.001). Ninety-three percent of the survived patients had ALT levels normalized or were on the improving trend during follow-up. Chronic hepatitis B was not associated with worse clinical outcomes. Conclusion: Reactive hepatitis is a common complication of SARS-coronavirus infection. Those patients with severe hepatitis had worse clinical outcome. © 2005 The WJG Press and Elsevier Inc. All rights reserved.
Persistent Identifierhttp://hdl.handle.net/10722/162824
ISSN
2013 Impact Factor: 2.433
2013 SCImago Journal Rankings: 1.022
ISI Accession Number ID
References

 

Author Affiliations
  1. Princess Margaret Hospital Hong Kong
  2. Prince of Wales Hospital Hong Kong
  3. Chinese University of Hong Kong
DC FieldValueLanguage
dc.contributor.authorChan, HLYen_US
dc.contributor.authorKwan, ACPen_US
dc.contributor.authorTo, KFen_US
dc.contributor.authorLai, STen_US
dc.contributor.authorChan, PKSen_US
dc.contributor.authorLeung, WKen_US
dc.contributor.authorLee, Nen_US
dc.contributor.authorWu, Aen_US
dc.contributor.authorSung, JJYen_US
dc.date.accessioned2012-09-05T05:23:58Z-
dc.date.available2012-09-05T05:23:58Z-
dc.date.issued2005en_US
dc.identifier.citationWorld Journal Of Gastroenterology, 2005, v. 11 n. 14, p. 2148-2153en_US
dc.identifier.issn1007-9327en_US
dc.identifier.urihttp://hdl.handle.net/10722/162824-
dc.description.abstractAim: Elevation of alanine aminotransferase (ALT) level is commonly seen among patients suffering from severe acute respiratory syndrome (SARS). We report the progression and clinical significance of liver derangement in a large cohort of SARS patient. Methods: Serial assay of serum ALT was followed in patients who fulfilled the WHO criteria of SARS. Those with elevated ALT were compared with those with normal liver functions for clinical outcome. Serology for hepatitis B virus (HBV) infection was checked. Adverse outcomes were defined as oxygen desaturation, need of intensive care unit (ICU) and mechanical ventilation and death. Results: Two hundred and ninety-four patients were included in this study. Seventy (24%) patients had elevated serum ALT on admission and 204 (69%) patients had elevated ALT during the subsequent course of illness. Using peak ALT >5×ULN as a cut-off and after adjusting for potential confounding factors, the odds ratio of peak ALT >5× ULN for oxygen desaturation was 3.24 (95%CI 1.23-8.59, P = 0.018), ICU care was 3.70 (95%CI 1.38-9.89, P = 0.009), mechanical ventilation was 6.64 (95%CI 2.22-19.81, P = 0.001) and death was 7.34 (95%CI 2.28-24.89, P = 0.001). Ninety-three percent of the survived patients had ALT levels normalized or were on the improving trend during follow-up. Chronic hepatitis B was not associated with worse clinical outcomes. Conclusion: Reactive hepatitis is a common complication of SARS-coronavirus infection. Those patients with severe hepatitis had worse clinical outcome. © 2005 The WJG Press and Elsevier Inc. All rights reserved.en_US
dc.languageengen_US
dc.publisherBeijing Baishideng BioMed Scientific Co., Ltd. The Journal's web site is located at http://www.wjgnet.com/1007-9327/index.htmen_US
dc.relation.ispartofWorld Journal of Gastroenterologyen_US
dc.subject.meshAdolescenten_US
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshAged, 80 And Overen_US
dc.subject.meshAlanine Transaminase - Blooden_US
dc.subject.meshChilden_US
dc.subject.meshFemaleen_US
dc.subject.meshFollow-Up Studiesen_US
dc.subject.meshHepatitis - Mortality - Pathology - Virologyen_US
dc.subject.meshHepatitis B - Complications - Mortalityen_US
dc.subject.meshHumansen_US
dc.subject.meshLiver - Pathology - Virologyen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshSevere Acute Respiratory Syndrome - Complications - Mortality - Pathologyen_US
dc.subject.meshSeverity Of Illness Indexen_US
dc.titleClinical significance of hepatic derangement in severe acute respiratory syndromeen_US
dc.typeArticleen_US
dc.identifier.emailLeung, WK:waikleung@hku.hken_US
dc.identifier.authorityLeung, WK=rp01479en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.pmid15810082en_US
dc.identifier.scopuseid_2-s2.0-17444367004en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-17444367004&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume11en_US
dc.identifier.issue14en_US
dc.identifier.spage2148en_US
dc.identifier.epage2153en_US
dc.identifier.isiWOS:000208102600016-
dc.publisher.placeChinaen_US
dc.identifier.scopusauthoridChan, HLY=16038785900en_US
dc.identifier.scopusauthoridKwan, ACP=35765436500en_US
dc.identifier.scopusauthoridTo, KF=7101911940en_US
dc.identifier.scopusauthoridLai, ST=7402937038en_US
dc.identifier.scopusauthoridChan, PKS=7403497792en_US
dc.identifier.scopusauthoridLeung, WK=7201504523en_US
dc.identifier.scopusauthoridLee, N=7402722286en_US
dc.identifier.scopusauthoridWu, A=7402998681en_US
dc.identifier.scopusauthoridSung, JJY=35405352400en_US

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