Results:
A total of 31 patients diagnosed with COVID-19 were identified in this study; however 2 patients did not have laboratory studies performed and were thus excluded. Additionally, one patient with transaminitis was found to have preeclampsia with severe features resulting in liver abnormalities, and therefore was excluded from review. Thus, 28 patients were included in the study; 9 patients were found to be COVID-19 positive with transaminitis and 19 patients were found to be COVID-19 positive without transaminitis. Additionally, infant outcomes were reviewed for patients who delivered at Westchester Medical Center. A total of 20 infants were included, including one set of twins and one intrauterine fetal demise (IUFD), both of which were in the transaminitis group. The additional infants’ statuses remained unknown and were presumed to have been delivered outside of Westchester Medical Center.
Laboratory values are listed in Table 1. The median AST level in the transaminitis group was 80.33 (45.28-100.75) and the median AST in the non-transaminitis group was 20.00 (18.18-26.42) (p <0.001). Additionally, the median ALT level for the transaminitis group was 79.73 (65.83-116.67) compared to 13.09 (10.25-27.25) in the non-transaminitis group. (p <0.001). There were no significant findings between the two groups for other laboratory values, including glucose, BUN and creatinine.
Maternal outcomes are shown in Table 2. The primary outcome of maternal ICU admission was found to be statistically significant, with more patients in the transaminitis group admitted to the ICU. 3/9 (33.3%) of transaminitis patients versus 0/19 (0.0%) of the non-transaminitis patients (p = 0.026) were admitted to the ICU. Significant secondary maternal outcomes included intubation and oxygen supplementation. 3/9 (33.3%) of patients in the transaminitis group were intubated while 0/19 (0.0%) of patients in the non-transaminitis group were intubated (p = 0.026). 6/9 (66.7%) of patients in the transaminitis group required oxygen supplementation while only 1/19 (5.3%) of patients in the non-transaminitis group required oxygen supplementation (p = 0.001). No maternal deaths were noted in either group. Patients with transaminitis stayed in the hospital longer than those without transaminitis, but this was not statistically significant (7.0 vs 3.0 days; p = 0.058). Finally, mode of delivery showed 6/7 (85.7%) patients in the transaminitis group were delivered by cesarean compared to 6/12 (50.0%) patients in the non-transaminitis group (p = 0.173).
None of the neonatal outcomes were found to have a statistically significant difference between the two groups (Table 3). The transaminitis group had a higher rate of preterm delivery, but this was not statistically significant. 3/8 (37.5%) patients in the transaminitis group experienced a preterm delivery with a median GA at delivery of 259.0 (228.0-263.5) days compared to 4/12 (33.3%) patients in the non-transaminitis group who experienced a preterm delivery with a median GA at delivery of 273.0 (242.3-274.0) days (p = 0.127). Median birth weight in the transaminitis group was also lower in the transaminitis group, 2730.0 (2509.5-3085.0) grams compared to 3225.0 (2600.0-3457.5) grams (p = 0.156). There was one IUFD in the transaminitis group compared to zero in the non-transaminitis group.