{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T02:38:27Z","timestamp":1777775907934,"version":"3.51.4"},"reference-count":18,"publisher":"Walter de Gruyter GmbH","issue":"1","license":[{"start":{"date-parts":[[2022,3,1]],"date-time":"2022-03-01T00:00:00Z","timestamp":1646092800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/3.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:bold>Background and aims.<\/jats:bold>\n                    Patients with COVID-19 frequently present abnormal elevated liver function tests of unknown clinical significance. We aimed to investigate the characteristics and factors influencing outcome in patients with confirmed SARS-CoV-2 infection and liver injury on admission.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Methods.<\/jats:bold>\n                    This is a retrospective observational study of patients hospitalized in two COVID units in Romania. Relevant data on clinical and laboratory parameters and medication administered during the admission were analyzed to identify predictors of a negative outcome. Patients with confirmed COVID-19 and liver function tests (LFTs) above the upper limit of normal were included in the analysis.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results.<\/jats:bold>\n                    From 1,207 patients, we identified 134 patients (11%) with abnormal LFTs during hospitalization. The majority of patients had mildly elevated levels and a predominantly cholestatic pattern of liver injury. Patients who received lopinavir\/ritonavir were more likely to have increased ALAT levels (\n                    <jats:italic>p<\/jats:italic>\n                    &lt;0.0001). Sixteen patients had pre-existing chronic liver disease, and they were more likely to suffer from severe COVID-19 (p=0.009) and have a negative outcome (p&lt;0.001), but on multivariate analysis, only the severity of COVID-19 was predictive of death (OR 69.9; 95% CI 6.4-761.4).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusions.<\/jats:bold>\n                    Mild liver injury is relatively common in COVID-19 and possibly influenced by medication. Patients with chronic liver disease are at high risk for negative outcome, but the severity of the infection is the only predictor of death.\n                  <\/jats:p>","DOI":"10.2478\/rjim-2021-0027","type":"journal-article","created":{"date-parts":[[2021,7,12]],"date-time":"2021-07-12T19:01:40Z","timestamp":1626116500000},"page":"49-55","source":"Crossref","is-referenced-by-count":2,"title":["Characteristics and outcomes of patients with COVID-19 and liver injury: a retrospective analysis and a multicenter experience"],"prefix":"10.2478","volume":"60","author":[{"given":"Andrei","family":"Voiosu","sequence":"first","affiliation":[{"name":"Gastroenterology Department , Colentina Clinical Hospital , Bucharest , Romania"},{"name":"Carol Davila University of Medicine and Pharmacy , Bucharest , Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adina","family":"Roman","sequence":"additional","affiliation":[{"name":"Gastroenterology Department , Mure\u0219 County Clinical Hospital , Romania"},{"name":"University of Medicine, Pharmacy Sciences and Technology \u201cGeorge Emil Palade\u201d T\u00e2rgu Mure\u0219 , Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruxandra","family":"Pop","sequence":"additional","affiliation":[{"name":"Gastroenterology Department , Colentina Clinical Hospital , Bucharest , Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alina","family":"Boeriu","sequence":"additional","affiliation":[{"name":"Gastroenterology Department , Mure\u0219 County Clinical Hospital , Romania"},{"name":"University of Medicine, Pharmacy Sciences and Technology \u201cGeorge Emil Palade\u201d T\u00e2rgu Mure\u0219 , Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristiana","family":"Popp","sequence":"additional","affiliation":[{"name":"Pathology Department , Colentina Clinical Hospital , Bucharest , Romania"},{"name":"Carol Davila University of Medicine and Pharmacy , Bucharest , Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sabina","family":"Zurac","sequence":"additional","affiliation":[{"name":"Pathology Department , Colentina Clinical Hospital , Bucharest , Romania"},{"name":"Carol Davila University of Medicine and Pharmacy , Bucharest , Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Theodor","family":"Voiosu","sequence":"additional","affiliation":[{"name":"Gastroenterology Department , Colentina Clinical Hospital , Bucharest , Romania"},{"name":"Carol Davila University of Medicine and Pharmacy , Bucharest , Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniela","family":"Dobru","sequence":"additional","affiliation":[{"name":"Gastroenterology Department , Mure\u0219 County Clinical Hospital , Romania"},{"name":"University of Medicine, Pharmacy Sciences and Technology \u201cGeorge Emil Palade\u201d T\u00e2rgu Mure\u0219 , Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bogdan","family":"Mateescu","sequence":"additional","affiliation":[{"name":"Gastroenterology Department , Colentina Clinical Hospital , Bucharest , Romania"},{"name":"Carol Davila University of Medicine and Pharmacy , Bucharest , Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2022,3,17]]},"reference":[{"key":"2026042914152679682_j_rjim-2021-0027_ref_001","doi-asserted-by":"crossref","unstructured":"1. 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Implications of liver injury in risk-stratification and management of patients with COVID-19. Hepatology international (2021): 1\u201311.10.1007\/s12072-020-10123-0786511833548030","DOI":"10.1007\/s12072-020-10123-0"},{"key":"2026042914152679682_j_rjim-2021-0027_ref_014","doi-asserted-by":"crossref","unstructured":"14. SIKKEMA, B. J., NICOLAAS, JS., VAN WIJNGAARDEN P. No association between COVID-19 related liver injury and the course of disease: a retrospective study. Scandinavian Journal of Gastroenterology 2021; 56(1): 68\u201371.10.1080\/00365521.2020.184248933119428","DOI":"10.1080\/00365521.2020.1842489"},{"key":"2026042914152679682_j_rjim-2021-0027_ref_015","doi-asserted-by":"crossref","unstructured":"15. YA-WEN A., et al. Liver function recovery of COVID-19 patients after discharge, a follow-up study. International journal of medical sciences 2021; 18 (1): 176.10.7150\/ijms.50691","DOI":"10.7150\/ijms.50691"},{"key":"2026042914152679682_j_rjim-2021-0027_ref_016","doi-asserted-by":"crossref","unstructured":"16. HAMID S., et al. WGO Guidance for the Care of Patients with COVID-19 and Liver Disease. Journal of Clinical Gastroenterology 2021; 55 (1): 1.10.1097\/MCG.0000000000001459","DOI":"10.1097\/MCG.0000000000001508"},{"key":"2026042914152679682_j_rjim-2021-0027_ref_017","doi-asserted-by":"crossref","unstructured":"17. ZHANG C, SHI L, WANG FS. Liver injury in COVID-19: management and challenges. Lancet Gastroenterol Hepatol. 2020;5(5):428-430.10.1016\/S2468-1253(20)30057-1","DOI":"10.1016\/S2468-1253(20)30057-1"},{"key":"2026042914152679682_j_rjim-2021-0027_ref_018","unstructured":"18. https:\/\/www.who.int\/publications\/i\/item\/clinical-management-of-covid-19"}],"container-title":["Romanian Journal of Internal Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/reference-global.com\/pdf\/10.2478\/rjim-2021-0027","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T18:19:01Z","timestamp":1777486741000},"score":1,"resource":{"primary":{"URL":"https:\/\/reference-global.com\/article\/10.2478\/rjim-2021-0027"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,1]]},"references-count":18,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,3,17]]},"published-print":{"date-parts":[[2022,3,1]]}},"alternative-id":["10.2478\/rjim-2021-0027"],"URL":"https:\/\/doi.org\/10.2478\/rjim-2021-0027","relation":{},"ISSN":["2501-062X"],"issn-type":[{"value":"2501-062X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,1]]}}}