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

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TitleClinical significance of hepatic derangement in severe acute respiratory syndrome
AuthorsChan, HLY3
Kwan, ACP1
To, KF3
Lai, ST1
Chan, PKS3
Leung, WK3
Lee, N3
Wu, A3
Sung, JJY2 3
Issue Date2005
PublisherBeijing Baishideng BioMed Scientific Co., Ltd. The Journal's web site is located at http://www.wjgnet.com/1007-9327/index.htm
CitationWorld Journal Of Gastroenterology, 2005, v. 11 n. 14, p. 2148-2153 [How to Cite?]
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.
ISSN1007-9327
2011 Impact Factor: 2.471
2011 SCImago Journal Rankings: 0.189
ReferencesReferences in Scopus
DC Field
Value
dc.contributor.authorChan, HLY
dc.contributor.authorKwan, ACP
dc.contributor.authorTo, KF
dc.contributor.authorLai, ST
dc.contributor.authorChan, PKS
dc.contributor.authorLeung, WK
dc.contributor.authorLee, N
dc.contributor.authorWu, A
dc.contributor.authorSung, JJY
dc.date.accessioned2012-09-05T05:23:58Z
dc.date.available2012-09-05T05:23:58Z
dc.date.issued2005
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.
dc.description.natureLink_to_subscribed_fulltext
dc.identifier.citationWorld Journal Of Gastroenterology, 2005, v. 11 n. 14, p. 2148-2153 [How to Cite?]
dc.identifier.epage2153
dc.identifier.issn1007-9327
2011 Impact Factor: 2.471
2011 SCImago Journal Rankings: 0.189
dc.identifier.issue14
dc.identifier.pmid15810082
dc.identifier.scopuseid_2-s2.0-17444367004
dc.identifier.spage2148
dc.identifier.urihttp://hdl.handle.net/10722/162824
dc.identifier.volume11
dc.languageeng
dc.publisherBeijing Baishideng BioMed Scientific Co., Ltd. The Journal's web site is located at http://www.wjgnet.com/1007-9327/index.htm
dc.publisher.placeChina
dc.relation.ispartofWorld Journal of Gastroenterology
dc.relation.referencesReferences in Scopus
dc.subject.meshAdolescent
dc.subject.meshAdult
dc.subject.meshAged
dc.subject.meshAged, 80 And Over
dc.subject.meshAlanine Transaminase - Blood
dc.subject.meshChild
dc.subject.meshFemale
dc.subject.meshFollow-Up Studies
dc.subject.meshHepatitis - Mortality - Pathology - Virology
dc.subject.meshHepatitis B - Complications - Mortality
dc.subject.meshHumans
dc.subject.meshLiver - Pathology - Virology
dc.subject.meshMale
dc.subject.meshMiddle Aged
dc.subject.meshSevere Acute Respiratory Syndrome - Complications - Mortality - Pathology
dc.subject.meshSeverity Of Illness Index
dc.titleClinical significance of hepatic derangement in severe acute respiratory syndrome
dc.typeArticle
Author Affiliations
  1. Princess Margaret Hospital Hong Kong
  2. Prince of Wales Hospital Hong Kong
  3. Chinese University of Hong Kong