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.