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| 1 | Upper-gastrointestinal bleeding secondary to peptic ulcer disease:Incidence and outcomes显示文摘AIM:To evaluate the incidence,surgery,mortality,and readmission of upper gastrointestinal bleeding(UGIB)secondary to peptic ulcer disease(PUD).METHODS:Administrative databases identified all hospitalizations for UGIB secondary to PUD in Alberta,Canada from 2004 to 2010(n=7079)using the International Classification of Diseases Codes(ICD-10).A subset of the data was validated using endoscopy reports.Positive predictive value and sensitivity with 95%confidence intervals(CI)were calculated.Incidence of UGIB secondary to PUD was calculated.Logistic regression was used to evaluate surgery,in-hospital mortality,and 30-d readmission to hospital with recurrent UGIB secondary to PUD.Co-variants accounted for in our logistic regression model included:age,sex,area of residence(i.e.,urban vs rural),number of Charlson comorbidities,presence of perforated PUD,undergoing upper endoscopy,year of admission,and interventional radiological attempt at controlling bleeding.A subgroup analysis(n=6356)compared outcomes of patients with gastric ulcers to those with duodenal ulcers.Adjusted estimates are presented as odds ratios(OR)with95%CI.RESULTS:The positive predictive value and sensitivity of ICD-10 coding for UGIB secondary to PUD were85.2%(95%CI:80.2%-90.2%)and 77.1%(95%CI:69.1%-85.2%),respectively.The annual incidence between 2004 and 2010 ranged from 35.4 to 41.2 per100000.Overall risk of surgery,in-hospital mortality,and 30-d readmission to hospital for UGIB secondary to PUD were 4.3%,8.5%,and 4.7%,respectively.Interventional radiology to control bleeding was performed in 0.6%of patients and 76%of these patients avoided surgical intervention.Thirty-day readmission significantly increased from 3.1%in 2004 to 5.2%in 2010(OR=1.07;95%CI:1.01-1.14).Rural residents(OR rural vs urban:2.35;95%CI:1.83-3.01)and older individuals(OR≥65 vs<65:1.57;95%CI:1.21-2.04)were at higher odds of being readmitted to hospital.Patients with duodenal ulcers had higher odds of dying(OR=1.27;95%CI:1.05-1.53),requiring surgery(OR=1.73;95%CI:1.34-2.23),and being readmitted to hospital(OR=1.54;95%CI:1.19-1.99)when compared to gastric ulcers.CONCLUSION:UGIB secondary to PUD,particularly duodenal ulcers,was associated with significant morbidity and mortality.Early readmissions increased over time and occurred more commonly in rural areas. | Samuel Quan Alexandra Frolkis Kaylee Milne Natalie Molodecky Hong Yang Elijah Dixon Chad G Ball Robert P Myers Subrata Ghosh Robert Hilsden Sander Veldhuyzen van Zanten Gilaad G Kaplan | 2014 | World Journal of Gastroenterology2014，20，46： | 21 |
| 2 | Extensively drug-resistant bacteria are an independent predictive factor of mortality in 130 patients with spontaneous bacterial peritonitis or spontaneous bacteremia显示文摘AIM: To evaluate the epidemiology and outcomes of culture-positive spontaneous bacterial peritonitis(SBP) and spontaneous bacteremia(SB) in decompensated cirrhosis.METHODS: We prospectively collected clinical, laboratory characteristics, type of administered antibiotic, susceptibility and resistance of bacteria to antibiotics in one hundred thirty cases(68.5% males) with positive ascitic fluid and/or blood cultures during the period from January 1, 2012 to May 30, 2014. All patients with SBP had polymorphonuclear cell count in ascitic fluid > 250/mm3. In patients with SB a thorough study did not reveal any other cause of bacteremia. The patients were followed-up for a 30-d periodfollowing diagnosis of the infection. The final outcome of the patients was recorded in the end of follow-up and comparison among 3 groups of patients according to the pattern of drug resistance was performed.RESULTS: Gram-positive-cocci(GPC) were found in half of the cases. The most prevalent organisms in a descending order were Escherichia coli(33), Enterococcus spp(30), Streptococcus spp(25), Klebsiella pneumonia(16), S. aureus(8), Pseudomanas aeruginosa(5), other Gram-negative-bacteria(GNB)(11) and anaerobes(2). Overall, 20.8% of isolates were multidrug-resistant(MDR) and 10% extensively drugresistant(XDR). Health-care-associated(HCA) and/or nosocomial infections were present in 100% of MDR/XDR and in 65.5% of non-DR cases. Meropenem was the empirically prescribed antibiotic in HCA/nosocomial infections showing a drug-resistance rate of 30.7% while third generation cephalosporins of 43.8%. Meropenem was ineffective on both XDR bacteria and Enterococcus faecium(E. faecium). All but one XDR were susceptible to colistin while all GPC(including E. faecium) and the 86% of GNB to tigecycline. Overall 30-d mortality was 37.7%(69.2% for XDR and 34.2% for the rest of the patients)(log rank, P = 0.015). In multivariate analysis, factors adversely affecting outcome included XDR infection(HR = 2.263, 95%CI: 1.005-5.095, P = 0.049), creatinine(HR = 1.125, 95%CI: 1.024-1.236, P = 0.015) and INR(HR =1.553, 95%CI: 1.106-2.180, P = 0.011).CONCLUSION: XDR bacteria are an independent lifethreatening factor in SBP/SB. Strategies aiming at restricting antibiotic overuse and rapid identification of the responsible bacteria could help improve survival. | Alexandra Alexopoulou Larisa Vasilieva Danai Agiasotelli Kyriaki Siranidi Sophia Pouriki Athanasia Tsiriga Marina Toutouza Spyridon P Dourakis | 2016 | World Journal of Gastroenterology2016，22，15： | 19 |
| 3 | Simultaneous development of diabetic ketoacidosis and Hashitoxicosis in a patient treated with pegylated interferon-alpha for chronic hepatitis C显示文摘Classical interferon-alpha has been shown to be correlated with the development of a variety of autoimmune disorders. A 38 year-old female patient developed simultaneously diabetic ketoacidosis and hyperthyroidism 5 mo following initiation of treatment with pegylated interferon-α and ribavirin for chronic hepatitis C. High titers of glutamic acid decarboxylase, antinuclear and thyroid (thyroid peroxidase and thyroglobulin) antibodies were detected. Antiviral treatment was withdrawn and the patient was treated with insulin for insulin-dependent diabetes mellitus and propranolol for hyperthyroidism. Twelve months after cessation of pegylated interferon-α therapy the patient was euthyroid without any medication but remained insulin-dependent. | Aspasia S Soultati Spyridon P Dourakis Alexandra Alexopoulou Melanie Deutsch Athanasios J Archimandritis | 2007 | World Journal of Gastroenterology2007，13，8： | 15 |
| 4 | Body-mass index correlates with severity and mortality in acute pancreatitis: A meta-analysis显示文摘BACKGROUND Obesity rates have increased sharply in recent decades. As there is a growing number of cases in which acute pancreatitis(AP) is accompanied by obesity, we found it clinically relevant to investigate how body-mass index(BMI) affects the outcome of the disease.AIM To quantify the association between subgroups of BMI and the severity and mortality of AP.METHODS A meta-analysis was performed using the Preferred Reporting Items for Systematic Review and Meta-Analysis(PRISMA) Protocols. Three databases(PubMed, EMBASE and the Cochrane Library) were searched for articles containing data on BMI, disease severity and mortality rate for AP. Englishlanguage studies from inception to 19 June 2017 were checked against our predetermined eligibility criteria. The included articles reported all AP cases with no restriction on the etiology of the disease. Only studies that classified AP cases according to the Atlanta Criteria were involved in the severity analyses. Odds ratios(OR) and mean differences(MD) were pooled using the random effects model with the DerSimonian-Laird estimation and displayed on forest plots. The meta-analysis was registered in PROSPERO under number CRD42017077890.RESULTS A total of 19 articles were included in our meta-analysis containing data on 9997 patients. As regards severity, a subgroup analysis showed a direct association between AP severity and BMI. BMI < 18.5 had no significant effect on severity;however, BMI > 25 had an almost three-fold increased risk for severe AP in comparison to normal BMI(OR = 2.87, 95%CI: 1.90-4.35, P < 0.001). Importantly,the mean BMI of patients with severe AP is higher than that of the non-severe group(MD = 1.79, 95%CI: 0.89-2.70, P < 0.001). As regards mortality, death rates among AP patients are the highest in the underweight and obese subgroups. A BMI < 18.5 carries an almost two-fold increase in risk of mortality compared to normal BMI(OR = 1.82, 95%CI: 1.32-2.50, P < 0.001). However, the chance of mortality is almost equal in the normal BMI and BMI 25-30 subgroups. A BMI >30 results in a three times higher risk of mortality in comparison to a BMI < 30(OR = 2.89, 95%CI: 1.10-7.36, P = 0.026).CONCLUSION Our findings confirm that a BMI above 25 increases the risk of severe AP, while a BMI > 30 raises the risk of mortality. A BMI < 18.5 carries an almost two times higher risk of mortality in AP. | Dalma Dobszai Péter Mátrai Zoltan Gyongyi Dezso Csupor Judit Bajor Balint Eross Alexandra Mikó Lajos Szakó Agnes Meczker Roland Hágendorn Katalin Márta Andrea Szentesi Péter Hegyi on behalf of the Hungarian Pancreatic Study Group | 2019 | World Journal of Gastroenterology2019，25，6： | 11 |
| 5 | Restoration of energy level in the early phase of acute pediatric pancreatitis显示文摘Acute pancreatitis (AP) is a serious inflammatory disease with rising incidence both in the adult and pediatric populations. It has been shown that mitochondrial injury and energy depletion are the earliest intracellular events in the early phase of AP. Moreover, it has been revealed that restoration of intracellular ATP level restores cellular functions and defends the cells from death. We have recently shown in a systematic review and meta-analysis that early enteral feeding is beneficial in adults; however, no reviews are available concerning the effect of early enteral feeding in pediatric AP. In this minireview, our aim was to systematically analyse the literature on the treatmentof acute pediatric pancreatitis. The preferred reporting items for systematic review(PRISMA-P) were followed, and the question was drafted based on participants, intervention, comparison and outcomes: P: patients under the age of twenty-one suffering from acute pancreatitis; I: early enteral nutrition (per os and nasogastric- or nasojejunal tube started within 48 h); C: nil per os therapy; O: length of hospitalization, need for treatment at an intensive care unit, development of severe AP, lung injury (including lung oedema and pleural effusion), white blood cell count and pain score on admission. Altogether, 632 articles (Pub Med: 131; EMBASE: 501) were found. After detailed screening of eligible papers, five of them met inclusion criteria. Only retrospective clinical trials were available. Due to insufficient information from the authors, it was only possible to address length of hospitalization as an outcome of the study. Our mini-meta-analysis showed that early enteral nutrition significantly(SD = 0.806, P = 0.034) decreases length of hospitalization compared with nil per os diet in acute pediatric pancreatitis. In this minireview, we clearly show that early enteral nutrition, started within 24-48 h, is beneficial in acute pediatric pancreatitis. Prospective studies and better presentation of research are crucially needed to achieve a higher level of evidence. | Dóra Mosztbacher Nelli Farkas Margit Solymár Gabriella Pár Judit Bajor ákos Szucs József Czimmer Katalin Márta Alexandra Mikó Zoltán Rumbus Péter Varjú Péter Hegyi Andrea Párniczky | 2017 | World Journal of Gastroenterology2017，23，6： | 8 |
| 6 | Aging related methylation influences the gene expression of key control genes in colorectal cancer and adenoma显示文摘AIM To analyze colorectal carcinogenesis and age-related DNA methylation alterations of gene sequences associated with epigenetic clock CpG sites. METHODS In silico DNA methylation analysis of 353 epigenetic clock Cp G sites published by Steve Horvath was performed using methylation array data for a set of 123 colonic tissue samples [64 colorectal cancer(CRC), 42 adenoma, 17 normal; GEO accession number: GSE48684]. Among the differentially methylated agerelated genes, secreted frizzled related protein 1(SFRP1) promoter methylation was further investigated in colonic tissue from 8 healthy adults, 19 normal children, 20 adenoma and 8 CRC patients using bisulfite-specific PCR followed by methylation-specific high resolution melting(MS-HRM) analysis. m RNA expression of age-related 'epigenetic clock' genes was studied using Affymetrix HGU133 Plus2.0 whole transcriptome data of 153 colonic biopsy samples(49 healthy adult, 49 adenoma, 49 CRC, 6 healthy children)(GEO accession numbers: GSE37364, GSE10714, GSE4183, GSE37267). Whole promoter methylation analysis of genes showing inverse DNA methylationgene expression data was performed on 30 colonic samples using methyl capture sequencing.RESULTS Fifty-seven age-related Cp G sites including hypermethylated PPP1R16 B, SFRP1, SYNE1 and hypomethylated MGP, PIPOX were differentially methylated between CRC and normal tissues(P < 0.05, ?β≥ 10%). In the adenoma vs normal comparison, 70 CpG sites differed significantly, including hypermethylated DKK3, SDC2, SFRP1, SYNE1 and hypomethylated CEMIP, SPATA18(P < 0.05, ?β≥ 10%). In MS-HRM analysis, the SFRP1 promoter region was significantly hypermethylated in CRC(55.0% ± 8.4 %) and adenoma tissue samples(49.9% ± 18.1%) compared to normal adult(5.2% ± 2.7%) and young(2.2% ± 0.7%) colonic tissue(P < 0.0001). DNA methylation of SFRP1 promoter was slightly, but significantly increased in healthy adults compared to normal young samples(P < 0.02). This correlated with significantly increased SFRP1 m RNA levels in children compared to normal adult samples(P < 0.05). In CRC tissue the mR NA expression of 117 agerelated genes were changed, while in adenoma samples 102 genes showed differential expression compared with normal colonic tissue(P < 0.05, logF C > 0.5). The change of expression for several genes including SYNE1, CLEC3 B, LTBP3 and SFRP1, followed the same pattern in aging and carcinogenesis, though not for all genes(e.g., MGP). CONCLUSION Several age-related DNA methylation alterations can be observed during CRC development and progression affecting the m RNA expression of certain CRC- and adenoma-related key control genes. | Orsolya Galamb Alexandra Kalmár Barbara Kinga Barták árpád V Patai Katalin Leiszter Bálint Péterfia Barnabás Wichmann Gábor Valcz Gábor Veres Zsolt Tulassay Béla Molnár | 2016 | World Journal of Gastroenterology2016，22，47： | 7 |
| 7 | Intralesional steroid is beneficial in benign refractory esophageal strictures:A meta-analysis显示文摘AIM To analyze the effect of intralesional steroid injections in addition to endoscopic dilation of benign refractory esophageal strictures.METHODS A comprehensive search was performed in three databases from inception to 10 April 2017 to identify trials, comparing the efficacy of endoscopic dilation to dilation combined with intralesional steroid injections. Following the data extraction, meta-analytical calculations were performed on measures of outcome by the randomeffects method of Der Simonian and Laird. Heterogeneity of the studies was tested by Cochrane's Q and I^2 statistics. Risk of quality and bias was assessed by the Newcastle Ottawa Scale and JADAD assessment tools.RESULTS Eleven articles were identified suitable for analyses, involving 343 patients, 235 cases and 229 controls in total. Four studies used crossover design with 121 subjects enrolled. The periodic dilation index(PDI) was comparable in 4 studies, where the pooled result showed a significant improvement of PDI in the steroid group(MD:-1.12 dilation/month, 95% CI:-1.99 to -0.25 P = 0.012; I^2 = 74.4%). The total number of repeat dilations(TNRD) was comparable in 5 studies and showed a non-significant decrease(MD:-1.17, 95%CI:-0.24-0.05, P = 0.057; I^2 = 0), while the dysphagia score(DS) was comparable in 5 studies and did not improve(SMD: 0.35, 95%CI:-0.38, 1.08, P = 0.351; I^2 = 83.98%) after intralesional steroid injection.CONCLUSION Intralesional steroid injection increases the time between endoscopic dilations of benign refractory esophageal strictures. However, its potential role needs further research. | László Szapáry Benedek Tinusz Nelli Farkas Katalin Márta Lajos Szakó Agnes Meczker Roland Hágendorn Judit Bajor Aron Vincze Zoltan Gyongyi Alexandra Mikó Dezso Csupor Péter Hegyi Balint Eross | 2018 | World Journal of Gastroenterology2018，24，21： | 7 |
| 8 | Long-term irritable bowel syndrome symptom control with reintroduction of selected FODMAPs显示文摘AIM To investigate the long-term effect of dietary education on a low fermentable oligosaccharide, disaccharide and polyol(FODMAP) diet on irritable bowel syndrome(IBS) symptoms and quality of life(Qo L).METHODS Participants with IBS(Rome III) were randomized to two groups. Group I commenced a low FODMAP diet at baseline. At three months, group II, so far a comparator group, crossed over to a low FODMAP diet while group I started re-challenging foods. All patients completed the IBS SSS(IBS symptom severity scoring system, 0-500 points increasing with severity), IBS Qo L questionnaire(0-100 increasing with Qo L), a FODMAP specific food frequency questionnaire and provided a stool sample at baseline, three and six months for microbiome analysis.RESULTS Fifty participants were enrolled into group I(n = 23) or group II(n = 27). Participants in both groups were similar in baseline values but with more men in group I. There was a significantly lower IBS SSS(275.6 ± 63.6 to 128.8 ± 82.5 vs 246.8 ± 71.1 to 203.6 ± 70.1)(P < 0.0002) and increased Qo L(68.5 ± 18.0 to 83 ± 13.4 vs 72.9 ± 12.8 to 73.3 ± 14.4)(P < 0.0001) in group I vs group II at 3 mo. The reduced IBS SSS was sustained at 6 mo in group I(160 ± 102) and replicated in group II(124 ± 76). Fiber intake decreased on the low FODMAP diet(33 ± 17 g/d to 21 ± 8 g/d)(P < 0.01) and after re-introducing FODMAP containing foods increased again to 27 ± 9 g/d. There was no change seen in the intestinal microbiome when participants adopted a low FODMAP diet.CONCLUSION This study demonstrated that a reduction in FODMAPs improves symptoms in IBS and this improvement can be maintained while reintroducing FODMAPs. | Ruth M Harvie Alexandra W Chisholm Jordan E Bisanz Jeremy P Burton Peter Herbison Kim Schultz Michael Schultz | 2017 | World Journal of Gastroenterology2017，23，25： | 5 |
| 9 | Clinical End Points in Coronary Stent Trials: A Case for Standardized Definitions显示文摘 | Donald E. Cutlip Stephan Windecker Roxana Mehran Ashley Boam David J. Cohen Gerrit-Anne van Es P Gabriel Steg Marie-angèle Morel Laura Mauri Pascal Vranckx Eugene McFadden Alexandra Lansky Martial Hamon Mitchell W. Krucoff Patrick W. Serruys | 2007 | Circulation2007，，17： | 4 |
| 10 | Alleviated mucosal and neuronal damage in a rat model of Crohn's disease显示文摘AIM:To establish a rat model suitable to investigate the repetitive relapsing inflammations(RRI)characteristic to Crohn’s disease.METHODS:Colitis was induced by 2,4,6-trinitrobenzenesulfonic acid(TNBS).RRI were mimicked by repeating administrations of TNBS.Tissue samples were taken from control,once,twice and three times treated rats from the inflamed and adjacent non-inflamed colonic segments at different timepoints during the acute intestinal inflammation.The means of the ulcerated area were measured to evaluate the macroscopic mu-cosal damage.The density of myenteric neurons was determined on whole mounts by Hu C/Hu D immunohistochemistry.Heme oxygenase-1(HO-1)expression was evaluated by molecular biological techniques.RESULTS:TNBS-treated rats displayed severe colitis,but the mortality was negligible,and an increase of body weight was characteristic throughout the experimental period.The widespread loss of myenteric neurons,and marked but transient HO-1 up-regulation were demonstrated after the first TNBS administration.After repeated doses the length of the recovery time and extent of the ulcerous colonic segments were markedly decreased,and the neuronal loss was on a smaller scale and was limited to the inflamed area.HO-1 m RNA level was notably greater than after a single dose and overexpression was sustained throughout the timepoints examined.Nevertheless,the HO-1protein up-regulation after the second TNBS treatment proved to be transient.Following the third treatment HO-1 protein expression could not be detected.CONCLUSION:Experimentally provoked RRI may exert a protective preconditioning effect against the mucosal and neuronal damage.The persistent up-regulation of HO-1 m RNA expression may correlate with this. | Petra Talapka Lajos István Nagy Alexandra Pál Marietta Zita Poles Anikó Berkó Mária Bagyánszki László Géza Puskás éva Fekete Nikolett Bódi | 2014 | World Journal of Gastroenterology2014，20，44： | 3 |
| 11 | Cholangiocarcinoma:A 7-year experience at a single center in Greece显示文摘AIM: To evaluate survival rate and clinical outcome of cholangiocarcinoma.METHODS: The medical records of 34 patients with cholangiocarcinoma,seen at a single hospital between the years 1999-2006,were retrospectively reviewed.RESULTS: Thirty-four patients with a median age of 75 years were included.Seventeen (50%) had painless jaundice at presentation.Sixteen (47.1%) were perihilar,15 (44.1%) extrahepatic and three (8.8%) intrahepatic.Endoscopic retrograde cholangiography (ERCP) and/or magnetic resonance cholangiography (MRCP) were used for the diagnosis.Pathologic confirmation was obtained in seven and positive cytological examination in three.Thirteen patients had co-morbidities (38.2%).Four cases were managed with complete surgical resection.All the rest of the cases (30) were characterized as non-resectable due to advanced stage of the disease.Palliative biliary drainage was performed in 26/30 (86.6%).The mean follow-up was 32 mo (95% CI,20-43 mo).Overall median survival was 8.7 mo (95% CI,2-16 mo).The probability of 1-year,2-year and 3-year survival was 46%,20% and 7%,respectively.The survival was slightly longer in patients who underwent resection compared to those who did not,but this difference failed to reach statistical significance.Patients who underwent biliary drainage had an advantage in survival compared to those who did not (probability of survival 53% vs 0% at 1 year,respectively,P = 0.038).CONCLUSION: Patients with cholangiocarcinoma were usually elderly with co-morbidities and/or advanced disease at presentation.Even though a slight amelioration in survival with palliative biliary drainage was observed,patients had dismal outcome without resection of the tumor. | Alexandra Alexopoulou Aspasia Soultati Spyros P Dourakis Larissa Vasilieva Athanasios J Archimandritis | 2008 | World Journal of Gastroenterology2008，14，40： | 3 |
| 12 | Chronic kidney disease severely deteriorates the outcome of gastrointestinal bleeding: A meta-analysis显示文摘AIM To understand the influence of chronic kidney disease(CKD) on mortality, need for transfusion and rebleeding in gastrointestinal(GI) bleeding patients.METHODS A systematic search was conducted in three databases for studies on GI bleeding patients with CKD or endstage renal disease(ESRD) with data on outcomes of mortality, transfusion requirement, rebleeding rate and length of hospitalization(LOH). Calculations were performed with Comprehensive Meta-Analysis software using the random effects model. Heterogeneity was tested by using Cochrane's Q and I2 statistics. Mean difference(MD) and OR(odds ratio) were calculated.RESULTS1063 articles(EMBASE: 589; PubM ed: 459; Cochrane: 15) were found in total. 5 retrospective articles and 1 prospective study were available for analysis. These 6 articles contained data on 406035 patients, of whom 51315 had impaired renal function. The analysis showed a higher mortality in the CKD group(OR = 1.786, 95%CI: 1.689-1.888, P < 0.001) and the ESRD group(OR = 2.530, 95%CI: 1.386-4.616, P = 0.002), and a rebleeding rate(OR = 2.510, 95%CI: 1.521-4.144, P < 0.001) in patients with impaired renal function. CKD patients required more unit red blood cell transfusion(MD = 1.863, 95%CI: 0.812-2.915, P < 0.001) and spent more time in hospital(MD = 13.245, 95%CI: 6.886-19.623, P < 0.001) than the controls.CONCLUSION ESRD increases mortality, need for transfusion, rebleeding rate and LOH among GI bleeding patients. Prospective patient registries and observational clinical trials are crucially needed. | Roland Hágendorn Nelli Farkas Aron Vincze Zoltán Gyongyi Dezso Csupor Judit Bajor Bálint Eross Péter Csécsei Andrea Vasas Zsolt Szakács László Szapáry Péter Hegyi Alexandra Mikó | 2017 | World Journal of Gastroenterology2017，23，47： | 3 |
| 13 | Abnormal liver chemistries as a predictor of COVID-19 severity and clinical outcomes in hospitalized patients显示文摘BACKGROUND Abnormal liver chemistries are common findings in patients with Coronavirus Disease 2019(COVID-19).However,the association of these abnormalities with the severity of COVID-19 and clinical outcomes is poorly understood AIM We aimed to assess the prevalence of elevated liver chemistries in hospitalized patients with COVID-19 and compare the serum liver chemistries to predict the severity and in-hospital mortality.METHODS This retrospective,observational study included 3380 patients with COVID-19 who were hospitalized in the Johns Hopkins Health System(Baltimore,MD,United States).Demographic data,clinical characteristics,laboratory findings,treatment measures,and outcome data were collected.Cox regression modeling was used to explore variables associated with abnormal liver chemistries on admission with disease severity and prognosis RESULTS A total of 2698(70.4%)had abnormal alanine aminotransferase(ALT)at the time of admission.Other more prevalent abnormal liver chemistries were aspartate aminotransferase(AST)(44.4%),alkaline phosphatase(ALP)(16.1%),and total bilirubin(T-Bil)(5.9%).Factors associated with liver injury were older age,Asian ethnicity,other race,being overweight,and obesity.Higher ALT,AST,T-Bil,and ALP levels were more commonly associated with disease severity.Multivariable adjusted Cox regression analysis revealed that abnormal AST and T-Bil were associated with the highest mortality risk than other liver injury indicators during hospitalization.Abnormal AST,T-Bil,and ALP were associated with a need for vasopressor drugs,whereas higher levels of AST,T-Bil,and a decreased albumin levels were associated with mechanical ventilation CONCLUSION Abnormal liver chemistries are common at the time of hospital admission in COVID-19 patients and can be closely related to the patient’s severity and prognosis.Elevated liver chemistries,specifically ALT,AST,ALP,and T-Bil levels,can be used to stratify risk and predict the need for advanced therapies in these patients. | Arunkumar Krishnan Laura Prichett Xueting Tao Saleh A Alqahtani James P Hamilton Esteban Mezey Alexandra T Strauss Ahyoung Kim James J Potter Po-Hung Chen Tinsay A Woreta | 2022 | World Journal of Gastroenterology2022，28，5： | 2 |
| 14 | Aquaculture potential of the common octopus (Octopus vulgaris Cuvier, 1797): a review显示文摘 | Paulo V P Pedro S Alexandra B | 2004 | Aquaculture2004，238，： | 1 |
| 15 | Ovotransferrin: Structure, bioactivities, and preparation显示文摘 | WU J P ALEXANDRA A L | 2011 | Food Research International2011，1016，10： | 1 |
| 16 | Strain variability of the biofilm - forming ability of Salmonella enterica under various environmental conditions 显示文摘 | Alexandra L Konstantinos P K | 2012 | International Journal of Food Microbiology2012，160，2： | 1 |
| 17 | Laser beam welding hard metals to steel显示文摘 | Alexandra P Costa Luisa Quintino Martin Greitmann | | 0，，141： | 1 |
| 18 | Expression of cyclin-dependent kinase inhibitors p16MTS1,P21WAF1 and p27KIP1 in HPV-positive and HPV-negative cervical adenocarcinomas显示文摘 | Karin M L Alexandra K P | 2001 | Virchows Arch2001，439，： | 1 |
| 19 | The impact of the coro-nary collateral circulation on mortality: a meta - analysis 显示文摘 | Meier P Hemingway H Alexandra J | 2012 | Eur Heart J2012，33，： | 1 |
| 20 | It is all about the emotional state:Managing tourists' experiences显示文摘 | ALEXANDRA B MIKE P ANDREAS S | | 0，，： | 1 |
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