Low ALT levels and a new diagnosis of congestive heart failure following COVID-19 infection
AimsCOVID-19 infection may result in complications including congestive heart failure (CHF). It is vital to identify factors associated with CHF post COVID so as to improve outcomes. The aim of this study was to determine whether baseline low alanine transaminase (ALT) levels are associated with new...
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Frontiers Media S.A.
2025-08-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2025.1470239/full |
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| author | Asher Shafrir Asher Shafrir Asher Shafrir Gil Dagan Gil Dagan Ronny Alcalai Ronny Alcalai David Leibowitz David Leibowitz |
| author_facet | Asher Shafrir Asher Shafrir Asher Shafrir Gil Dagan Gil Dagan Ronny Alcalai Ronny Alcalai David Leibowitz David Leibowitz |
| author_sort | Asher Shafrir |
| collection | DOAJ |
| description | AimsCOVID-19 infection may result in complications including congestive heart failure (CHF). It is vital to identify factors associated with CHF post COVID so as to improve outcomes. The aim of this study was to determine whether baseline low alanine transaminase (ALT) levels are associated with new diagnosis of CHF following infection with COVID-19.Methods and resultsThe study was a retrospective cohort study of patients in the Meuchedet Health Fund database. The analysis was performed on all subjects aged 18 years and older who tested positive for SARS-CoV-2 and had ALT levels measured prior to infection. Patients were excluded if diagnosed with congestive heart failure or cirrhosis prior to COVID-19, or if they died within 30 days of SARS-CoV-2 contraction. The study endpoint was a new diagnosis of CHF as recorded in the subject's electronic medical record.Results131,953 adult patients infected with COVID were included in the cohort. Of them, 205 patients (0.16%) were diagnosed with CHF following COVID-19 infection. The occurrence of CHF was significantly higher in the low ALT group (0.34% vs. 0.14%, p- value < 0.001). This difference was more prominent when analyzing patients aged 50 and older (1.4% vs. 0.35, p-value < 0.001). In a multivariate logistic regression, pre-morbid low ALT remained significantly associated with the occurrence of post COVID-19 CHF (OR—1.95, 95% CI −1.03 to 2.53).ConclusionsThis study demonstrates that low ALT levels prior to infection with COVID-19 is associated with a new diagnosis of CHF following infection. Patients with low ALT levels prior to COVID-19 infection should have cardiovascular complaints post COVID carefully assessed. |
| format | Article |
| id | doaj-art-a1b14c1309e348ecb50da0882f87b080 |
| institution | Kabale University |
| issn | 2297-055X |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj-art-a1b14c1309e348ecb50da0882f87b0802025-08-20T03:39:10ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-08-011210.3389/fcvm.2025.14702391470239Low ALT levels and a new diagnosis of congestive heart failure following COVID-19 infectionAsher Shafrir0Asher Shafrir1Asher Shafrir2Gil Dagan3Gil Dagan4Ronny Alcalai5Ronny Alcalai6David Leibowitz7David Leibowitz8Jerusalem District, Meuhedet Health Maintenance Organization, Tel Aviv, IsraelDepartment of Gastroenterology and Hepatology, Hadassah-Hebrew University Medical Center, Jerusalem, IsraelFaculty of Medicine, Hebrew University of Jerusalem, Jerusalem, IsraelFaculty of Medicine, Hebrew University of Jerusalem, Jerusalem, IsraelHeart Institute, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, IsraelFaculty of Medicine, Hebrew University of Jerusalem, Jerusalem, IsraelHeart Institute, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, IsraelFaculty of Medicine, Hebrew University of Jerusalem, Jerusalem, IsraelHeart Institute, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, IsraelAimsCOVID-19 infection may result in complications including congestive heart failure (CHF). It is vital to identify factors associated with CHF post COVID so as to improve outcomes. The aim of this study was to determine whether baseline low alanine transaminase (ALT) levels are associated with new diagnosis of CHF following infection with COVID-19.Methods and resultsThe study was a retrospective cohort study of patients in the Meuchedet Health Fund database. The analysis was performed on all subjects aged 18 years and older who tested positive for SARS-CoV-2 and had ALT levels measured prior to infection. Patients were excluded if diagnosed with congestive heart failure or cirrhosis prior to COVID-19, or if they died within 30 days of SARS-CoV-2 contraction. The study endpoint was a new diagnosis of CHF as recorded in the subject's electronic medical record.Results131,953 adult patients infected with COVID were included in the cohort. Of them, 205 patients (0.16%) were diagnosed with CHF following COVID-19 infection. The occurrence of CHF was significantly higher in the low ALT group (0.34% vs. 0.14%, p- value < 0.001). This difference was more prominent when analyzing patients aged 50 and older (1.4% vs. 0.35, p-value < 0.001). In a multivariate logistic regression, pre-morbid low ALT remained significantly associated with the occurrence of post COVID-19 CHF (OR—1.95, 95% CI −1.03 to 2.53).ConclusionsThis study demonstrates that low ALT levels prior to infection with COVID-19 is associated with a new diagnosis of CHF following infection. Patients with low ALT levels prior to COVID-19 infection should have cardiovascular complaints post COVID carefully assessed.https://www.frontiersin.org/articles/10.3389/fcvm.2025.1470239/fullCOVID-19congestive heart failureALTfrailtysarcopena |
| spellingShingle | Asher Shafrir Asher Shafrir Asher Shafrir Gil Dagan Gil Dagan Ronny Alcalai Ronny Alcalai David Leibowitz David Leibowitz Low ALT levels and a new diagnosis of congestive heart failure following COVID-19 infection Frontiers in Cardiovascular Medicine COVID-19 congestive heart failure ALT frailty sarcopena |
| title | Low ALT levels and a new diagnosis of congestive heart failure following COVID-19 infection |
| title_full | Low ALT levels and a new diagnosis of congestive heart failure following COVID-19 infection |
| title_fullStr | Low ALT levels and a new diagnosis of congestive heart failure following COVID-19 infection |
| title_full_unstemmed | Low ALT levels and a new diagnosis of congestive heart failure following COVID-19 infection |
| title_short | Low ALT levels and a new diagnosis of congestive heart failure following COVID-19 infection |
| title_sort | low alt levels and a new diagnosis of congestive heart failure following covid 19 infection |
| topic | COVID-19 congestive heart failure ALT frailty sarcopena |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2025.1470239/full |
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