INTRODUCTION: Liver injury has been noted during the disease course of the novel coronavirus infection (COVID-19) We evaluated for ethnic and racial disparities in COVID-19 patients presenting with liver injury METHODS: We reviewed 11,265 individual patient charts with confirmed COVID-19 infection admitted to our 12 hospitals in our health system between March 1 to April 30, 2020 Race and ethnicity data were collected by self-report in pre-specified categories Race categories included white, black, asian, other/multiracial and unknown, while ethnicity included non-Hispanic, Hispanic and unknown Baseline liver chemistries were collected within 24 hours of presentation Exclusion criteria included age less than 18 years and missing baseline data Patients were categorized as having liver injury if they had any elevation above the upper limit of normal set by American Association for the Study of Liver Diseases in alanine aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP) or bilirubin Multivariate analysis was performed after adjusting for covariates RESULTS: After exclusion,10,856 patients were included in our study Overall, there was a significant difference of the prevalence of liver injury amongst the various races and ethnicities (Table 1) On adjusted analysis, Asian (OR: 1 65 [95% CI: [1 37-2 02]) and multi-racial patients (OR: 1 65 [95% CI: 1 37-2 02]) were more likely to develop liver injury compared to white patients A non-Hispanic ethnicity had a lower association with sustaining liver injury (OR: 0 77 [95% CI: [0 75-1 03]) (Table 2) CONCLUSION: There are racial and ethnic disparities seen in patients with liver injury during COVID-19 infection Our data suggest that Asian patients are more likely compared to white patients to sustain liver injury Non-Hispanic ethnicity conferred protective effect against liver injury These results may implicate a component underlying genetic predisposition for liver injury during COVID- 19 infection (Table Presented)
Racial/ethnic disparities of liver injury in COVID-19 infected patients