Pre-infection liver function is associated with all-cause mortality among hemodialysis patients with SARS-CoV-2 Omicron variant infection

Background There is ample evidence to suggest that patients infected with SARS-CoV-2 Omicron variant may experience liver dysfunction. However, the impact of pre-infection liver function on postinfection mortality rates remains inadequately researched.Methods Data from 847 hemodialysis (HD) patients...

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Main Authors: Quanchao Zhang, Caibao Lu, Han Wang, Shaofa Wu, Lili Jiang, Jie Li, Zhifen Wu, Bingshuang Tang, Bingfeng Yang, Shengli Liao, Liao Wang, Hongwei Chen, Moqi Li, Wenchang He, Yiqin Wang, Jin He, Jinghong Zhao, Ling Nie
Format: Article
Language:English
Published: Taylor & Francis Group 2024-12-01
Series:Renal Failure
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Online Access:https://www.tandfonline.com/doi/10.1080/0886022X.2024.2425069
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author Quanchao Zhang
Caibao Lu
Han Wang
Shaofa Wu
Lili Jiang
Jie Li
Zhifen Wu
Bingshuang Tang
Bingfeng Yang
Shengli Liao
Liao Wang
Hongwei Chen
Moqi Li
Wenchang He
Yiqin Wang
Jin He
Jinghong Zhao
Ling Nie
author_facet Quanchao Zhang
Caibao Lu
Han Wang
Shaofa Wu
Lili Jiang
Jie Li
Zhifen Wu
Bingshuang Tang
Bingfeng Yang
Shengli Liao
Liao Wang
Hongwei Chen
Moqi Li
Wenchang He
Yiqin Wang
Jin He
Jinghong Zhao
Ling Nie
author_sort Quanchao Zhang
collection DOAJ
description Background There is ample evidence to suggest that patients infected with SARS-CoV-2 Omicron variant may experience liver dysfunction. However, the impact of pre-infection liver function on postinfection mortality rates remains inadequately researched.Methods Data from 847 hemodialysis (HD) patients, diagnosed with Omicron across six HD centers between December 2022 and February 2023, were analyzed. Initial liver function assessments were conducted, following which patients were monitored for mortality outcomes. The stepwise multivariable Cox regression analysis and receiver operating characteristic (ROC) curves were utilized to identify the predictors of mortality.Results From the total, 98 patients (11.6%) succumbed, with a majority (80/98) within a month postinfection. The deceased patients were observed to be mostly older males with an increased prevalence of diabetes and tumors, signifying higher AST and C-reactive protein levels. These patients also exhibited lower hemoglobin, albumin, and prealbumin levels. An elevated AST [per 1 IU increment; HR 1.04 (95% CI 1–1.04), p = 0.026], AST/ALT ratio [per 1 increment; HR 1.52 (95% CI 1.27–2.36), p = 0.004], and reduced prealbumin [per 10 mg/L increment; HR 0.93 (95% CI 0.9–0.96), p < 0.001] were discovered to be independent indicators of an increased mortality risk. Notably, AST, AST/ALT ratio, and prealbumin proved significant predictors of mortality (AUC values were 0.59, 0.65, and 0.79 respectively).Conclusions This study underscores that pre-infection liver function, specifically AST, AST/ALT ratio, and prealbumin levels, substantially influence the mortality rates in HD patients following Omicron infection. Therefore, careful consideration of these liver function parameters could guide superior patient management strategies and potentially decrease mortality rates within this at-risk population.
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spelling doaj-art-e819ae760b6141daa4377f024462b2432025-08-20T02:38:10ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492024-12-0146210.1080/0886022X.2024.2425069Pre-infection liver function is associated with all-cause mortality among hemodialysis patients with SARS-CoV-2 Omicron variant infectionQuanchao Zhang0Caibao Lu1Han Wang2Shaofa Wu3Lili Jiang4Jie Li5Zhifen Wu6Bingshuang Tang7Bingfeng Yang8Shengli Liao9Liao Wang10Hongwei Chen11Moqi Li12Wenchang He13Yiqin Wang14Jin He15Jinghong Zhao16Ling Nie17Department of Nephrology, the Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Chongqing Clinical Research Center of Kidney and Urology Diseases, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, ChinaDepartment of Nephrology, the Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Chongqing Clinical Research Center of Kidney and Urology Diseases, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, ChinaDepartment of Endocrinology and Nephrology, Chongqing General Hospital, Chongqing, ChinaDepartment of Nephrology, Youyang Hospital, A Branch of the First Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of Nephrology, Youyang Hospital, A Branch of the First Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaUrology and Kidney Disease Center, Yongchuan People’s Hospital of Chongqing, Chongqing, ChinaUrology and Kidney Disease Center, Yongchuan People’s Hospital of Chongqing, Chongqing, ChinaDepartment of Nephrology and Endocrinology, ChongQingBishan District Hospital of Traditional Chinese Medicine, Chongqing, ChinaDepartment of Nephrology and Endocrinology, ChongQingBishan District Hospital of Traditional Chinese Medicine, Chongqing, ChinaHemodialysis Center of Nanchuan Hospital of Traditional Chinese Medicine, Chongqing, ChinaHemodialysis Center of Nanchuan Hospital of Traditional Chinese Medicine, Chongqing, ChinaDepartment of Nephrology, the Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Chongqing Clinical Research Center of Kidney and Urology Diseases, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, ChinaDepartment of Nephrology, the Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Chongqing Clinical Research Center of Kidney and Urology Diseases, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, ChinaDepartment of Nephrology, the Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Chongqing Clinical Research Center of Kidney and Urology Diseases, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, ChinaDepartment of Nephrology, the Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Chongqing Clinical Research Center of Kidney and Urology Diseases, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, ChinaDepartment of Endocrinology and Nephrology, Chongqing General Hospital, Chongqing, ChinaDepartment of Nephrology, the Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Chongqing Clinical Research Center of Kidney and Urology Diseases, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, ChinaDepartment of Nephrology, the Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Chongqing Clinical Research Center of Kidney and Urology Diseases, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, ChinaBackground There is ample evidence to suggest that patients infected with SARS-CoV-2 Omicron variant may experience liver dysfunction. However, the impact of pre-infection liver function on postinfection mortality rates remains inadequately researched.Methods Data from 847 hemodialysis (HD) patients, diagnosed with Omicron across six HD centers between December 2022 and February 2023, were analyzed. Initial liver function assessments were conducted, following which patients were monitored for mortality outcomes. The stepwise multivariable Cox regression analysis and receiver operating characteristic (ROC) curves were utilized to identify the predictors of mortality.Results From the total, 98 patients (11.6%) succumbed, with a majority (80/98) within a month postinfection. The deceased patients were observed to be mostly older males with an increased prevalence of diabetes and tumors, signifying higher AST and C-reactive protein levels. These patients also exhibited lower hemoglobin, albumin, and prealbumin levels. An elevated AST [per 1 IU increment; HR 1.04 (95% CI 1–1.04), p = 0.026], AST/ALT ratio [per 1 increment; HR 1.52 (95% CI 1.27–2.36), p = 0.004], and reduced prealbumin [per 10 mg/L increment; HR 0.93 (95% CI 0.9–0.96), p < 0.001] were discovered to be independent indicators of an increased mortality risk. Notably, AST, AST/ALT ratio, and prealbumin proved significant predictors of mortality (AUC values were 0.59, 0.65, and 0.79 respectively).Conclusions This study underscores that pre-infection liver function, specifically AST, AST/ALT ratio, and prealbumin levels, substantially influence the mortality rates in HD patients following Omicron infection. Therefore, careful consideration of these liver function parameters could guide superior patient management strategies and potentially decrease mortality rates within this at-risk population.https://www.tandfonline.com/doi/10.1080/0886022X.2024.2425069HemodialysisOmicronliver functionmortality
spellingShingle Quanchao Zhang
Caibao Lu
Han Wang
Shaofa Wu
Lili Jiang
Jie Li
Zhifen Wu
Bingshuang Tang
Bingfeng Yang
Shengli Liao
Liao Wang
Hongwei Chen
Moqi Li
Wenchang He
Yiqin Wang
Jin He
Jinghong Zhao
Ling Nie
Pre-infection liver function is associated with all-cause mortality among hemodialysis patients with SARS-CoV-2 Omicron variant infection
Renal Failure
Hemodialysis
Omicron
liver function
mortality
title Pre-infection liver function is associated with all-cause mortality among hemodialysis patients with SARS-CoV-2 Omicron variant infection
title_full Pre-infection liver function is associated with all-cause mortality among hemodialysis patients with SARS-CoV-2 Omicron variant infection
title_fullStr Pre-infection liver function is associated with all-cause mortality among hemodialysis patients with SARS-CoV-2 Omicron variant infection
title_full_unstemmed Pre-infection liver function is associated with all-cause mortality among hemodialysis patients with SARS-CoV-2 Omicron variant infection
title_short Pre-infection liver function is associated with all-cause mortality among hemodialysis patients with SARS-CoV-2 Omicron variant infection
title_sort pre infection liver function is associated with all cause mortality among hemodialysis patients with sars cov 2 omicron variant infection
topic Hemodialysis
Omicron
liver function
mortality
url https://www.tandfonline.com/doi/10.1080/0886022X.2024.2425069
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