Gatt Ehud Raz, Zilber Eyal, Perelman Max, Landau Nitsan, Yakir Maya, Glick Noam, Negru Liat, Segal Gad, Itelman Edward
Sackler faculty of medicine, Tel Aviv University, Tel Aviv, Israel.
Internal Department "T", Tel Hashomer Hospital, Ramat Gan, Israel.
J Frailty Sarcopenia Falls. 2023 Sep 1;8(3):148-154. doi: 10.22540/JFSF-08-148. eCollection 2023 Sep.
COVID-19 geoperdize lives. Not all the risk factors for negative outcomes are known. Sarcopenia and frailty are common, negatively affecting clinical outcomes. Studies have shown that sarcopenia and frailty are associated with worse outcomes. Our objective was to examine whether low ALT (Alanine-aminotranferase), a surrogate marker for sarcopenia, is associated with worse clinical outcomes among hospitalized COVID-19 patients.
We reviewed cases of COVID-19 in a tertiary hospital, during three COVID-19 waves and examined correlations between ALT and mortality using crude, univariate and multivariate analysis for age, gender, hypertension, Chronic obstructive pulmonary disease and Congestive heart failure.
357 patients were included in this analysis. Median age was 69, 54% were males. Median ALT was 19 IU/L. During follow-up, 73 (20%) died. Patients with low ALT were more likely to die (HR 1.82, 95% CI 1.06-3.09, P=0.028). Other predictors for mortality were low albumin, background COPD, dyslipidemia, dementia, and malignancy. The multivariate analysis showed that low ALT was still an independent predictor of poor prognosis (HR 1.7, 95% CI 1.0-2.9, P=0.049).
In our analysis of COVID-19 patients, low ALT levels were independently associated with increased risk of mortality, both as standalone and when incorporated into a multivariate analysis.
新冠病毒病（COVID-19）危及生命。并非所有导致不良后果的风险因素都已知。肌肉减少症和衰弱很常见，会对临床结果产生负面影响。研究表明，肌肉减少症和衰弱与更差的结果相关。我们的目的是研究低丙氨酸氨基转移酶（ALT），一种肌肉减少症的替代标志物，是否与住院COVID-19患者更差的临床结果相关。
我们回顾了一家三级医院在三波COVID-19疫情期间的病例，并使用年龄、性别、高血压、慢性阻塞性肺疾病和充血性心力衰竭的粗分析、单变量分析和多变量分析来研究ALT与死亡率之间的相关性。
本分析纳入了357例患者。中位年龄为69岁，54%为男性。中位ALT为19 IU/L。在随访期间，73例（20%）死亡。ALT水平低的患者死亡可能性更大（风险比[HR]1.82，95%置信区间[CI]1.06 - 3.09，P = 0.028）。其他死亡预测因素包括低白蛋白、有慢性阻塞性肺疾病史、血脂异常、痴呆和恶性肿瘤。多变量分析显示，低ALT仍然是预后不良的独立预测因素（HR 1.7，95% CI 1.0 - 2.9，P = 0.049）。
在我们对COVID-19患者的分析中，低ALT水平与死亡风险增加独立相关，无论是单独分析还是纳入多变量分析时都是如此。
