A significant proportion of these patients had abnormal liver tests prehospitalization (AST 25.9%, ALT 38.0%, ALP 56.8%, and TBIL 44.4%). Most patients with abnormal liver tests at admission had minimal elevations 1-2× the upper limit of normal (ULN AST 63.7%, ALT 63.5%, ALP 80.0%, and TBIL 75.7%).
Abnormal liver tests were commonly observed in hospitalized patients with COVID-19, both at admission (AST 66.9%, ALT 41.6%, ALP 13.5%, and TBIL 4.3%) and peak hospitalization (AST 83.4%, ALT 61.6%, ALP 22.7%, and TBIL 16.1%). Clinical characteristics, liver tests (aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, total bilirubin, and albumin) at three time points (preinfection baseline, admission, and peak hospitalization), and hospitalization outcomes (severe COVID-19, intensive care unit admission, mechanical ventilation, and death) were analyzed. We conducted a retrospective cohort study of 1,827 patients with confirmed COVID-19 who were hospitalized within the Yale-New Haven Health System between Maand April 23, 2020. Liver injury has been reported as a nonpulmonary manifestation of COVID-19, but characterization of liver test abnormalities and their association with clinical outcomes is incomplete. Adding nurse practitioners can yield improved clinical outcomes (lower hospital mortality and fewer transfers to intensive care), but with a potential economic expense (longer hospital stays and higher costs).The coronavirus-19 disease (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 virus, is associated with significant morbidity and mortality attributable to pneumonia, acute respiratory distress syndrome, and multiorgan failure. The results were unchanged when models were adjusted for potential confounders. Hospital mortality was lower in the nurse practitioner group as was transfer to more intensive care level however, the nurse practitioner group had longer length of stay (geometric mean = 5.80 days for nurse practitioners, 3.63 days for no nurse practitioners p < 0.0001) and higher cost per patient (geometric mean = USD 6631 vs. Of the 382 patients included in this study, 263 were assigned to the nurse practitioner group. Outcomes included length of hospital stay, in-hospital mortality, admission costs, 30-day readmissions, transfer to a more intensive care level, and discharge order time. The admissions department allocated patients as beds became available and nurse practitioners were assigned to patients until their caseload was reached. A retrospective cohort study evaluated adult patients admitted by private physicians (without house staff or non-physician providers) to a general medical-surgical unit in an academic medical center. Our purpose was to determine the effect of adding nurse practitioners in a complementary role on the quality and efficiency of care of hospitalized patients. However, little data exist examining the impact of these providers. The role of advanced practice providers has expanded in the hospital setting.
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