Background – Studies investigating the relation between baseline liver abnormality and COVID-19 patients’ outcomes during hospitalization are scarce. The aim of the study is to address and characterize this clinically important association. Methods – Retrospective single-center study of adults hospitalized with COVID-19 infection for whom the baseline liver function tests up to one year prior to the admission were available. The study cohort included hospitalized patients from COVID-19 wards and specialized COVID-19 intensive care unit. Subjects were divided into a normal and abnormal baseline LFT groups that were then compared with respect to demographic characteristics, co-morbidities and patients’ outcomes during hospitalization. Results – 133 of 444 subjects met the inclusion criteria and were included in the study. Of them, 50/133 (37.6%) had abnormal baseline LFTs. The mean age of the cohort subjects was 65.7 ± 22.1 years and the mean BMI was 28.7 ± 13.0. Subjects with abnormal LFTs were more likely to die (22% versus 4.8%, p = 0.004) or require mechanical ventilation (16% versus 4.8%, p = 0.03) during hospitalization when compared to their normal LFT counterparts. Multivariate analysis revealed that abnormal baseline LFT (OR 6, 95% CI 2.0 – 18.4) was the strongest predictor of death or requiring mechanical ventilation followed by diabetes mellitus (OR 4.5, 95% CI 1.3 – 14.8) and congestive heart failure (OR 3.9, 95% CI 1.2 – 12.5). Conclusion - patients known to have a baseline LFTs abnormality appear to be at an increased risk for death or mechanical ventilation during hospitalization with COVID-19.

Background: The liberal administration of hydroxychloroquine-sulphate (HCQ) to COVID-19 patients has raised concern regarding the risk of QTc prolongation and cardiac arrhythmias, particularly when prescribed with azithromycin. We evaluated the incidence of QTc prolongation among moderately and severely ill COVID-19 patients treated with HCQ and of the existence of concomitant alternative causes. Methods: All COVID-19 patients treated with HCQ (between Mar 1 and Apr 14, 2020) in a tertiary medical center were included. Clinical characteristics and relevant risk factors were collected from the electronic medical records. Individual patient QTc intervals were determined before and after treatment with HCQ. The primary outcome measure sought was a composite endpoint comprised of either an increase ≥ 60 milliseconds (ms) in the QTc interval compared with pretreatment QTc, and/or a maximal QTc interval >500 ms. Results: Ninety patients were included. Median age was 65 years (IQR 55-75) and 57 (63%) were male. Thirty-nine patients (43%) were severely or critically ill. Hypertension and obesity were common (n=23 each, 26%). QTc prolongation evolved in fourteen patients (16%). Age > 65 years, congestive heart failure, severity of disease, C-reactive protein level, hypokalemia and furosemide treatment, were all associated with QTc prolongation. Adjusted analysis showed that QTc prolongation was five times more likely with hypokalemia [OR 5, (95% CI, 1.3-20)], and three times more likely with furosemide treatment [OR 3 (95% CI, 1.01-13.7)]. Conclusion: In patients treated with HCQ, QTc prolongation was associated with the presence of traditional risk factors such as hypokalemia and furosemide treatment.