Liver function recovery of COVID-19 patients after discharge, a follow-up study

Abstract

Objective: The aim of this study was to observe the liver function recovery of COVID-19 patients after discharge. Patients and Methods: A total of 253 discharged COVID-19 patients in Shenzhen city, China were selected. The clinical characteristics of these patients were assessed. A 2-month follow-up and laboratory hematology test were performed to examine the status of patients' liver function. Results: Patients combined with liver diseases, especially fatty liver, are more likely to progress to severe condition (P<0.05). Patients in severe condition and those with liver diseases have higher rates of liver injuries during hospitalization, characterized by a significant increase in alanine aminotransferase (ALT) and aspartate aminotransferase (AST, P<0.01). The ALT, AST/ALT, gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP), total protein (TP), albumin (ALB), and A/G levels showed significant differences in comparison with the control group (P<0.05, and P<0.001); and the outlier ratio of A/G, ALT, GGT and ALP of patients remained abnormal higher within 14 days after discharge (P<0.001). Liver injuries of COVID-19 patients may be related to the epidemiological characteristics, clinical indexes, basic diseases, symptoms, drug treatment during hospitalization and the complications. Indicators of liver function were correlated with cardiac function, renal function, thyroid function, lipid metabolism, glucose metabolism, immune index, leukocyte, erythrocyte, hemoglobin and platelet related indexes. The outlier ratio of TP, ALB and GLB remained extremely low throughout the follow-up period; the outlier ratio of ALT, AST and GGT decreased below 10% from a high level at 40 days after discharged. However, the outlier ratio of A/G, AST/ALT and ALP remained high during the follow-up period. Conclusions: Abnormal liver function might indicate worse recovery of COVID-19 patients. Changes in liver function should be emphasized during long-term follow-up of COVID-19 patients after hospital discharge; the necessity of employing appropriate interventions for liver function repair should be emphasized.

Clinical characteristics and impacts of traditional Chinese medicine treatment on the convalescents of COVID-19

“…This might be caused by viral infection or the use of potentially hepatotoxic drugs. In a previous study, we found that a significant proportion of discharged COVID-19 patients with abnormal liver function indicators even after 2 months of follow-up 18 . In the present study, serum aspartate aminotransferase (AST) level of convalescents was back to normal.…”

“…More than 38 million of COVID-19 patients have been discharged from hospitals worldwide. Our previous study found that despite meeting discharge criteria, some discharged COVID-19 patients still had some symptoms, such as depression, anxiety, fatigue, loss of appetite, abnormal blood parameters, etc., 15 - 18 , 22 . TCM might play roles of antivirus, anti-inflammation and immunoregulation, and target organs protection in the management of COVID-19 23 .…”

“…Despite meeting the discharge criteria, a significant proportion of discharged COVID-19 patients still had some symptoms including psychiatric symptoms, gastrointestinal reaction and low immunity 15 , 16 ; some of them were even found to be recurrence of positive SARS‑CoV‑2 viral RNA one or more times 17 . Therefore, dynamic surveillance of physical conditions such as peripheral blood system, liver function, kidney function and cardiovascular system, and how to promote recovery of discharged COVID-19 patients from the symptoms are very meaningful 18 . The aims of the present study was to retrospectively analyze clinical characteristics of discharged COVID-19 patients in Shenzhen, China, calculate the proportion who used TCM, analyze the effectiveness of TCM for recovery period, and preliminarily reveal its underlying mechanisms.…”

Functional and tissue enrichment analyses suggest that SARS-CoV-2 infection affects host metabolism and catabolism mediated by interference on host proteins

“…Figure 1a and b represent the biological process categories impacted by coronaviruses infection—metabolism, catabolism, symbiosis, immune response, and a series of intracellular mechanisms (localization, transport/export, organization, cell cycle, and others). Despite COVID-19 and SARS not beingmetabolic diseases, infections by SARS-CoV and SARS-CoV-2 are associated with metabolism disruption [ 6 , 8 , 25 , 26 ]. In this context, Fig.…”

“…2b and c ). As said before, infections by coronaviruses lead to functional disruptions of metabolic tissues or organs [ 6 , 25 , 40 ]. Here, the ubiquitous presence of ACE2 (angiotensin-converting enzyme 2) host receptors [ 41 ] provides opportunities for the virus to access these metabolic organs.…”