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INTRODUCTION: COVID-19 affects the liver, causing alteration in liver biochemistry tests such as aspartate transferase (AST), alanine transferase (ALT), alkaline phosphatase (ALP), total bilirubin and albumin. OBJECTIVE: To determine the prevalence of alteration in liver functions tests and associated factors for severity among Peruvian COVID-19 patients. MATERIALS AND METHODS: A descriptive, retrospective and cross-sectional study was performed in 4 public hospitals in Peru. Patients admitted to hospitalization wards and intensive care units with a diagnosis COVID-19 were enrolled. The evaluation of AST, ALT, ALP, totalbilirubin and albumin was performed. Associations with demographic and medical data were assessed. RESULTS: 1,100 patients were enrolled, of which 81.7% had altered liver function tests. Only 2.8% of the patients had cirrhosis and 2.1% hepatitis B/C virus. AST and ALT were altered at admission in 64.7% and 63.7%, of the patients respectively. Factors associated with liver injury were: being female OR=0.53 (95% CI: 0.39-0.73; p<0.01), dyslipidemia OR=1.72 (95% CI: 1.10-2.70; p=0.01), previous medication OR=1.56 (95% CI: 1.12 -2.16, p<0.01) and fever OR=1.43 (95% CI: 1.03-1.199, p=0.03). Disease severity was associated with levels of AST and ALT (p<0.01). Patients taking self-medication OR=1.56 (95% CI: 1.12-2.16; p<0.01) and paracetamol OR= 1.41 (95% CI:1.01-1.98; p=0.04) had higher risk of liver injury. Meanwhile, corticosteroids OR=0.55 (95% CI: 0.38-0.78; p<0.01) and enoxaparin OR=0.53 (95% CI: 0.35- 0.81; p<0.01) were protective factors. CONCLUSIONS: Peruvian patients with COVID-19 presented high prevalence of alteration in liver function tests, high levels of AST and ALT were related to disease severity.
Assuntos
COVID-19 , Estudos Transversais , Feminino , Humanos , Fígado , Testes de Função Hepática , Peru/epidemiologia , Estudos Retrospectivos , SARS-CoV-2RESUMO
BACKGROUND AND AIMS: The coronavirus disease 2019 (COVID-19) outbreak has led to an unprecedented public health crisis. In Peru, although the quarantine is no longer mandatory, it was during the first months of 2020. To date, no studies have assessed the impact of the COVID-19 on the eating patterns and lifestyle context in the country. We aimed to describe the eating habits, lifestyle behaviors and stress during the COVID-19 pandemic quarantine among Peruvian adults. METHODS: We conducted a cross-sectional study. We used an online survey to collect information regarding eating habits, self-perceived stress and sedentary lifestyle among adults over 18 years of age residing in Lima-Peru and who complied with strict home quarantine. We presented our data according to the weight variation of the participants. RESULTS: A total of 686 were finally included in the study. The 82.9% were female, the median BMI was 25.97 kg/m2 (IQR: 23.37-29.41) and 68.2% reported a significant variation in their weight (38.9% increased and 29.3% lost weight). All bad habits were significantly associated with weight gain, except for prolonged fasting. Additionally, a sitting time longer than usual (p = 0.001), being in front of a screen for more than five hours in the last week (p = 0.002), and most of the stressful scenarios were significantly associated with weight gain. CONCLUSION: Almost four out of ten participants gained weight during the quarantine. This was associated with unhealthy eating habits, physical inactivity, and stressful scenarios.
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Introduction: COVID-19 affects the liver, causing alteration in liver biochemistry tests such as aspartate transferase (AST), alanine transferase (ALT), alkaline phosphatase (ALP), total bilirubin and albumin. Objective: To determine the prevalence of alteration in liver functions tests and associated factors for severity among Peruvian COVID-19 patients. Materials and methods: A descriptive, retrospective and cross-sectional study was performed in 4 public hospitals in Peru. Patients admitted to hospitalization wards and intensive care units with a diagnosis COVID-19 were enrolled. The evaluation of AST, ALT, ALP, total bilirubin and albumin was performed. Associations with demographic and medical data were assessed. Results: 1,100 patients were enrolled, of which 81.7% had altered liver function tests. Only 2.8% of the patients had cirrhosis and 2.1% hepatitis B/C virus. AST and ALT were altered at admission in 64.7% and 63.7%, of the patients respectively. Factors associated with liver injury were: being female OR=0.53 (95% CI: 0.39-0.73; p<0.01), dyslipidemia OR=1.72 (95% CI: 1.10-2.70; p=0.01), previous medication OR=1.56 (95% CI: 1.12 -2.16, p<0.01) and fever OR=1.43 (95% CI: 1.03-1.199, p=0.03). Disease severity was associated with levels of AST and ALT (p<0.01). Patients taking self-medication OR=1.56 (95% CI: 1.12-2.16; p<0.01) and paracetamol OR= 1.41 (95% CI:1.01-1.98; p=0.04) had higher risk of liver injury. Meanwhile, corticosteroids OR=0.55 (95% CI: 0.38-0.78; p<0.01) and enoxaparin OR=0.53 (95% CI: 0.35- 0.81; p<0.01) were protective factors. Conclusions: Peruvian patients with COVID-19 presented high prevalence of alteration in liver function tests, high levels of AST and ALT were related to disease severity.
Introducción: La COVID-19 afecta al hígado, provocando alteración en las pruebas de función hepática como aspartato aminotransferasa (AST), alanina aminotransferasa (ALT), fosfatasa alcalina (FA), bilirrubina total y albúmina. Objetivo: Determinar la prevalencia de alteración en las pruebas de función hepática y su asociación con la severidad en pacientes peruanos con COVID-19. Materiales y métodos: Se realizó un estudio descriptivo, retrospectivo y transversal en 4 hospitales públicos del Perú. Se incluyeron pacientes admitidos en hospitalización y unidades de cuidados intensivos con diagnóstico de COVID-19. Se realizó la evaluación de AST, ALT, FA, bilirrubina total y albúmina. Se evaluaron las asociaciones con datos demográficos y médicos. Resultados: Se incluyeron 1,100 pacientes, de los cuales el 81,7% presentaba alteraciones en las pruebas de función hepática. Solo el 2,8% de los pacientes tenía cirrosis y el 2,1% infección por virus de la hepatitis B / C. Se encontraron niveles alterados de AST y ALT al ingreso en el 64,7% y 63,7% de los pacientes, respectivamente. Los factores asociados con alteración en pruebas de función hepáticas fueron: ser mujer OR = 0,53 (IC 95%: 0,39-0,73; p <0,01), dislipidemia OR=1,72 (IC 95%: 1,10-2,70; p=0,01), uso de medicación previa OR = 1,56 (IC del 95%: 1,12 -2,16, p <0,01) y fiebre OR = 1,43 (IC del 95%: 1,03-1,199, p = 0,03). La gravedad de la enfermedad se asoció con los niveles de AST y ALT (p <0,01). Los pacientes que se automedicaban OR = 1,56 (IC 95%: 1,12-2,16; p <0,01) y tomaban paracetamol OR = 1,41 (IC 95%: 1,01-1,98; p =0,04) tenían mayor riesgo de injuria hepática. Mientras tanto, los corticosteroides OR=0,55 (IC del 95%: 0,38-0,78; p <0,01) y la enoxaparina OR=0,53 (IC del 95%: 0,35-0,81; p <0,01) fueron factores protectores. Conclusiones: los pacientes peruanos con COVID-19 presentaron alta prevalencia de alteración en las pruebas de función hepática, niveles elevados de AST y ALT se relacionaron con la gravedad de la enfermedad.
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To assess the epidemiology of hepatitis B virus (HBV) infection among men who have sex with men (MSM) in Peru, we evaluated the prevalence and associated risk factors for HBV serologic markers among participants of a HIV sentinel surveillance conducted in 2002-2003. The standardized prevalences for total antibodies to hepatitis B core antigen (anti-HBc) and hepatitis B surface antigen (HBsAg) were 20.2% and 2.8%, respectively. Individuals with human immunodeficiency virus (HIV-1) infection had significantly higher anti-HBc (44.3% versus 19.3%) and HBsAg (9.5% versus 2.3%) prevalences than uninfected men. Increasing age (adjusted odds ratio [AOR] = 1.06), versatile sexual role (AOR = 1.59), sex in exchange for money/gifts (AOR = 1.58), syphilis (AOR = 1.74), HIV-1 infection (AOR = 1.64), and herpes simplex virus type 2 (HSV-2, AOR = 2.77) infection were independently associated with anti-HBc positivity, whereas only HIV-1 infection (AOR = 3.51) and generalized lymph node enlargement (AOR = 3.72) were associated with HBsAg positivity. Pre-existing HBV infection is very common among Peruvian MSM and was correlated with sexual risk factors. MSM in Peru constitute a target population for further HBV preventive and treatment interventions.