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Clinical Outcome of Patients with COVID Transaminitis Given Essential Phospholipids in a Tertiary Medical Center: A Retrospective Cohort Study

Background: The COVID-19 pandemic has been a global public health challenge since the initial emergence of the novel coronavirus. COVID-19 infections can cause multi-systemic effects, including gastrointestinal symptoms such as abdominal pain, loose bowel movement, and increased liver enzymes, leading to transaminitis. The use of essential phospholipids, with its anti-inflammatory, antioxidant, antifibrinogenic, antiapoptotic, membrane-protective, and lipid-regulating effects, may be a viable treatment option for COVID-19-induced transaminitis. Methods: This retrospective cohort study aims to evaluate the clinical outcomes of administering essential phospholipids to adult Filipino patients with COVID-19 Transaminitis admitted in a tertiary medical center from July 2021 to February 2022. A total of 238 COVID-19 patients admitted met the inclusion criteria. The primary treatment arm consists of 156 patients who received essential phospholipids during admission, while the control arm consists of the remaining 82 patients who did not receive essential phospholipids. The study's statistical analysis utilized Wilcoxon Signed Rank Test, Mann-Whitney U Test, and Chi-square test. The computed minimum sample size is 109 based on a confidence value of 95%, a margin of error of 5, 50% population proportion, and a population size of 150. Results: The study shows that the prevalence of COVID-19 Transaminitis is 70%. There is also a significant decrease from baseline to repeat serum AST and ALT levels for patients who took essential phospholipids. Although not statistically significant, there is a trend toward a decrease in mortality rate from those patients who took essential phospholipids compared to those who did not (16% vs. 24% respectively). There was also higher mortality rate for those patients with COVID-19 transaminitis (21%), from those who did not have COVID-19 transaminitis (16%), however, the study did not reach the level of significance. There is a significant difference in the number of COVID-19 critical patients with transaminitis compared to those who did not have transaminitis (51% vs 33%). Conclusion: The prevalence of transaminitis in COVID-19 infection is high. essential phospholipids may hold promise as an effective treatment option for COVID-19 transaminitis. The presence of transaminitis in COVID-19 patients appears to have a significant impact on the severity of the disease or the course of treatment.

COVID-19, Transaminitis, Essential Phospholipids

APA Style

Daniel Frederick Cruz Ulep, Adolf Lim-Teodoro, Emmanuel Monsayac. (2023). Clinical Outcome of Patients with COVID Transaminitis Given Essential Phospholipids in a Tertiary Medical Center: A Retrospective Cohort Study. International Journal of Gastroenterology, 7(2), 57-63. https://doi.org/10.11648/j.ijg.20230702.14

ACS Style

Daniel Frederick Cruz Ulep; Adolf Lim-Teodoro; Emmanuel Monsayac. Clinical Outcome of Patients with COVID Transaminitis Given Essential Phospholipids in a Tertiary Medical Center: A Retrospective Cohort Study. Int. J. Gastroenterol. 2023, 7(2), 57-63. doi: 10.11648/j.ijg.20230702.14

AMA Style

Daniel Frederick Cruz Ulep, Adolf Lim-Teodoro, Emmanuel Monsayac. Clinical Outcome of Patients with COVID Transaminitis Given Essential Phospholipids in a Tertiary Medical Center: A Retrospective Cohort Study. Int J Gastroenterol. 2023;7(2):57-63. doi: 10.11648/j.ijg.20230702.14

Copyright © 2023 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

1. Suresh Kumar VC, Harne PS, Mukherjee S, et al. Transaminitis is an indicator of mortality in patients with COVID-19: A retrospective cohort study. World J Hepatol. 2020; 12 (9): 619-627. doi: 10.4254/wjh.v12.i9.619.
2. Gundermann KJ, Gundermann S, Drozdzik M, Mohan Prasad VG. Essential phospholipids in fatty liver: a scientific update. Clin Exp Gastroenterol. 2016; 9: 105-117. Published 2016 May 5. doi: 10.2147/CEG.S96362.
3. Cheung KS, Hung IFN, Chan PPY, et al. Gastrointestinal Manifestations of SARS-CoV-2 Infection and Virus Load in Fecal Samples From a Hong Kong Cohort: Systematic Review and Meta-analysis. Gastroenterology 2020; 159: 81.
4. Kaafarani HMA, El Moheb M, Hwabejire JO, et al. Gastrointestinal Complications in Critically Ill Patients With COVID-19. Ann Surg 2020; 272: e61.
5. Sun JK, Liu Y, Zou L, et al. Acute gastrointestinal injury in critically ill patients with COVID-19 in Wuhan, China. World J Gastroenterol 2020; 26: 6087.
6. Zhao X, Lei Z, Gao F, et al. The impact of coronavirus disease 2019 (COVID-19) on liver injury in China: A systematic review and meta-analysis. Medicine (Baltimore) 2021; 100: e24369.
7. Phipps MM, Barraza LH, LaSota ED, et al. Acute Liver Injury in COVID-19: Prevalence and Association with Clinical Outcomes in a Large U. S. Cohort. Hepatology 2020; 72: 807.
8. Zhang C, Shi L, Wang FS. Liver injury in COVID-19: management and challenges. Lancet Gastroenterol Hepatol 2020; 5: 428.
9. Rodriguez, B. J. P. and Ebola, L. E. (2020) Prevalence of Elevated Transaminases Among Adult Filipino Patients with COVID-19 Infection Admitted at a Tertiary Hospital in Metro Manila from March to August 2020: A Cross-sectional Analytical Study. Phil J Gastro [Preprint].
10. Chai X, Hu L, Zhang Y, Han W, Lu Z, Ke A, Zhou J, Shi G, Fang N, Fan J, Cai J, Fan Ji LF. ACE2 expression in cholangiocytes may cause liver damage after 2019 nCoV infection. 2020 Preprint. Available from: bioRxiv: 931766.
11. Pizarras, S. J. et al. (2021) ‘Clinical Characteristics and Outcomes of COVID-19 Patients with Gastrointestinal Manifestations Seen in a Tertiary Hospital: A Retrospective, Cohort Study’, Phil J Gastro, 10 (2).