Reply to :Aminotransferases disorders associated with venous thromboembolic events in patients infected with COVID-19

Dear Editor,

Zhu et al. published an interesting correspondence [1] regarding the article we published in October 2020 in Annals of Hepatology [2].

We revised our statistics using the same software: for ALT (normal <61IU / L) mean 57.3 ± 36.1 UI/L: 48.9 ± 31.5 in patients without venous thrombo embolism (VTE) event (PNOVTE) versus 91.5 ± 71.0 in patients with VTE (PVTE), p value = 0.059. The p value are the same for the other parameters: D-dimer (in our cohort, only 40 patients/46 had a D-dimer sampling): mean 2914 ± 5362 ng/l: 1779 ± 2941 in PNOVTE versus 7315 ± 9550 in PVTE p = 0.021. For NT-proBNP (39 patients of 46 had a NT-proBNP sampling: mean 2388 ± 5361 pg /mL, 2879 ± 5927 in PNOVTE versus 2735 ± 6227 in PVTE, p = 0.52. For CPK, only 20 patients/46 had a CPK sampling: mean 124 ± 83.3 UI/L, 134 ± 83.3 in PNOVTE versus 46.5 ± 19.1 in PVTE p = 0.079 (Tables 1 and 2). The univariate analysis were estimated with Mann-Whitney test. P values less than 0.05 were considered to indicate statistical significance.

Table 1.

Descriptive analysis.

	mean (sd)	median [Q25-75]	min	max	n
ALT	57.3 (36.1)	46.5 [28.2; 72.8]	11.0	149	46/46
NT-proBNP	2388 (5361)	362 [128; 1192]	30.0	24514	39/46
CPK	122 (80.0)	116 [62.2; 135]	33.0	328	20/46
D-dimer	2914(5362)	986 [572; 2079]	132	25000	40/46

Table 2.

Patient characteristics.

VARIABLE	Total 46 patientsmean	36 NO VTEmean	10 VTEmean	P value
Age (years)	67.2 ± 12.0	67.1 ± 12.1	67.6 ± 12.4	0.79
F (n,%) M (n,%)	24 (52%) 22 (48%)	20 (56%) 16 (44%)	4 (40%) 6 (60%)	0.48
AST (<37UI/L)	50.3 ± 34.1	50.4 ± 34.7	50.1 ± 33.7	0.94
ALT (<61UI/L)	57.3 ± 36.1	48.9 ± 31.5	91.5 ± 71.0	0.059
Total Biluribin (1 − 17um/L)	9.90 ± 4.01	10.1 ± 4.41	9.40 ± 2.84	1
D-dimer (<500 ng/mL)	2914 ± 5362	1779 ± 2941	7315 ± 9550	0.021
GammaGT (15 − 85 UI/L)	136 ± 152	128 ± 155	173 ± 145	0.41
Alkaline phosphatase (45 − 117 UI/L)	149 ± 206	159 ± 230	114 ± 70.7	0.71
CRP (0 − 3 mg/L)	83.3 ± 61.8	69.7 ± 53.1	110 ± 72.8	0.11
GF >90 ml/min)	78.6 ± 30.0	78.1 ± 31.1	80.7 ± 26.5	1
BMI (kg/m^2)	27.9 ± 4.14	27.8 ± 4.03	28.3 ± 4.74	0.72
aPTT (0.86 − 1.20)	1.09 ± 0.298	1.09 ± 0.236	1.10 ± 0.456	0.19
NT-proBNP (<194 pg/mL)	2388 ± 5361	2879 ± 5927	2735 ± 6227	0.52
CPK (26 − 192 UI/L)	124 ± 83.3	134 ± 83.3	46.5 ± 19.1	0.079
Hemoglobin (13.5 − 16.9 g/dL)	12.7 ± 2.05	12.5 ± 1.87	13.2 ± 2.78	0.23
LDH (57 − 241 UI/L)	360 ± 151	361 ± 159	356 ± 134	1
Lymphocyes (1.26 − 3.35 × 10.9/L)	1.28 ± 1.39	1.28 ± 1.57	1.27 ± 0.475	0.16
Platelets (166 − 308 × 10.9/L)	280 ± 108	280 ± 108	301 ± 87.1	0.36
WBC (3.91 − 10.9 × 10.9/L)	7.85 ± 4.08)	6.83 ± 3.52	11.2 ± 4.15	<0.01
Prothrombin time %	78.3 ± 13.9	78.3 ± 15.0)	78.4 ± 10.7	0.91
Home ICU Follow-up care Death	8 (18%) 4 (11%) 3(6.5%)	22(63%) 6(17%) 4(11%) 2(8.6%)	7 (70%) 2(20%) 0 (0%) 1(10%)	0.87
Hypertension	25 (54.3%)	22(5.5%)	3(30%)
Diabetes	7 (15.2%)	7(19.4%)	0(0%)
Dyslipidemia	11 (24%)	10 (27.8%)	1(10%)
Digestive sypmtoms	4 (8.7%)	3 (8.3%)	1 (10%)
History/liver diseases (n,%)	0 (0%)	0(%)	0(%)
Smoking	10 (21.7%)	10 (27.8%)	0(0%)
Lymphopenia	29 (63%)	24(67%)	5(50%)
Active cancer	0 (0%)	0 (0%)	0 (0%)
History of cancer (n,%)	3 (6.5%)	3 (8.3%)	0(0%)
History of VTE (n,%)	3 (6.5%)	2(5.5%)	1(10%)
Chronic Renal Failure	5 (8.7%)	5 (13.9%)	0(0%)
Haemodialysis	2(4.3%)	2(5.6%)	0(0%)
Sleep Apnea Syndrome	6 (13%)	4 (11%)	2(20%)
Septicaemia	0 (0%)	0 (0%)	0 (0%)

BMI = Body mass index. CRP = C-reactive protein. LDH = Lactic aciddehydrogenase. ICU = Intensive Care Unit. NT-proBNP = N-terminal prohormone brain natriuretic peptide. aPTT = Activated partial thromblastine time. WBC = White blood cells. CPK = creatine phosphokinase.

Declaration of funding interests

None.

Conflict of interest

The authors have no conflict of interest to declare.