MATERIAL AND METHODS
In this multicentric retrospective study, adult patients (≥18 years of age) with confirmed COVID‐19 who were hospitalized for the treatment were enrolled. The study was approved by the local ethics committee of Lokman Hekim University with the number of 2021/065. Informed consent was obtained from all of the patients.
Diagnosis of COVID‐19 was assessed by using nasopharyngeal swap reverse transcriptase-polymerase chain reaction (Real-Time PCR) according to WHO guideline 10. Patients were treated in line with the recommendations of Turkey’s Health Ministry COVID-19 adult patient treatment guidelines 11. Demographic features, complete medical history, and laboratory findings of the study participants at admission are obtained from the hospital records. The laboratory data including hemoglobin level, white blood cell count, neutrophil and lymphocyte counts, ALT, AST, GGT, and ALP levels, serum creatinine level, concentrations of D-dimer, and C-reactive protein (CRP) levels were recorded. All data were obtained at the admission of the patients before treatment.
Patients with missing data, having any known chronic hepatobiliary diseases, non-alcoholic fatty liver disease, patients with alcohol abuse, hepatobiliary malignancies and receiving drugs known to have cholestatic effects other than those used in COVID-19 management, end-stage renal disease and patients on hemodialysis were excluded from the study. 483 patients were evaluated and it was decided to include 269 patients due to strict exclusion criteria.
Patients were grouped regarding their ICU requirements during their hospitalization periods. Moreover, the outcomes of the patients at the end of the treatment were also recorded. Patients whose treatment or hospitalization periods were continuing during the data collection were not included in the study.