The Elevation of LIVER Enzymes in Patients with Atrial Fibrillation and COVID-19 Is a Marker of Bad Evolution and Mortality

Introduction: The COVID-19 pandemic reflects liver damage. A study carried out in China (Guan WJ et al. N Engl J Med. 2020) reported that in more than 21% of cases there was an elevation of liver enzymes (ELE), with only 2.1% of them having previous liver disease. ELE is frequent in anticoagulated patients and is associated with an increased cardiovascular risk and bleeding complications2,3. It is necessary to evaluate the impact of ELE in patients with atrial fibrillation (AF) and COVID-19 Methods: Multicenter, retrospective and observational study that consecutively included patients admitted with COVID-19 during the months of March and April 2020. The patients were followed were followed up until 30 days after discharge or death. termino en inglés ¿??Anticoagulation was chosen at the clinical discretion. The main variables investigated were the value of liver enzymes (AST, ALT, GGT) at admission, during the first week (peak value) and at hospital discharge. Patients who achieved a 3-fold higher level of ELE(> 120UI) were described as high-risk transaminasemia (HRT). The number of bleedings, thromboembolic events, as well as all-cause mortality were evaluated. Statistical analysis was performed with SPSS 21.0 (SPSS Inc., Chicago, IL). Results: A total of 235 patients were included. The mean age was 79 years [standard deviation (SD) 7.9. years]. The demographic characteristics of the patients with and without HRT are summarized in Table 1. The median follow-up was 59 days (SD 29 days). In AF patients, ELE values rose significantly on admission with respect to discharge p Disclosures Olivera: Daiichi Sankyo:Consultancy, Speakers Bureau;BAYER:Consultancy;Boehringer Ingelheim:Consultancy, Speakers Bureau;Pfizer:Consultancy, Speakers Bureau.Campoy Castaño:Boehringer Ingelheim:Consultancy;Daiichi Sankyo:Speakers Bureau.Sierra:Astellas:Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees;Novartis:Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau;Abbvie:Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau;Jazz Pharmaceuticals:Research Funding;Pfizer:Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau;Daiichi Sankyo:Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau;Roche:Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees;Gilead-Kite:Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees.