Pattern of liver injury in adult patients with COVID-19: a retrospective analysis of 105 patients

Abstract

【Background】Recent studies reported that patients with coronavirus disease-2019 (COVID-19) might have liver injury. However, few data on the combined analysis and change patterns of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total bilirubin (TBil) have been shown.【Methods】 This is a single-center retrospective study. A total of 105 adult patients hospitalized for confirmed COVID-19 in Beijing Ditan Hospital between January 12, and March 17, 2020 were included, and divided into mild and severe groups. We compared liver functional test results between the two groups. Category of ALT change during the disease course was also examined.【Results】 56.2% of the patients had unnormal ALT, AST, or total TBil throughout the course of the disease, but in 91.4% cases the level of ALT, AST or TBil ≤ 3 fold of the upper normal range. The overall distribution of ALT, AST, and TBil were all significantly difference between mild and severe group (p<0.05).The percentage of the patients with both elevated ALT and AST was 12.7% in mild cases vs. 46.2% in severe cases (p = 0.001). 34.6% severe group patients started to have abnormal ALT after admission，and 73.4% of all patients had normal ALT before discharge.【Conclusion】Elevated liver function index is very common in patients with COVID-19 infection, and the level were less than 3 × ULN，but most are reversible. The abnormality of 2 or more indexes is low in the patients with COVID-19, but it is more likely to occur in the severe group.

The prevalence of comorbidities and associated risk factors among Covid-19 deceased in Mizoram, India

“…Our study did not indicate differences between the age groups and laboratory parameters, except for alkaline phosphatase (P = 0.002), where the signi icant difference was related to previous indings (Wang et al, 2020b). Laboratory pro ile abnormalities with SARS CoV-2 were like the earlier SARS CoV infection (Wang et al, 2020a).…”

COVID 19 and liver: An A–Z literature review

“…During treatment, 19% of patients had elevated liver function parameters but most patients had only mild and isolated elevations in ALT and AST. Most of the patients were discharged with normal liver markers [45] . Recent data from other studies suggest that liver enzymes become more frequently, and more severely deranged during the course of hospitalization [12 , 34] .…”

Liver injury in COVID-19: clinical features and treatment management

“…During the treatment period, 19% of the patients had elevated liver function parameters, but most of the patients had only mild and isolated elevation of ALT and AST, and most of the patients had normal liver indexes at discharge. However, patients with severe disease were or isolated elevation, and most of them were normal after discharge more likely to have abnormal liver function [32]. Generally speaking [12], in mild cases of COVID-19, the increase of liver enzymes is usually mild, and severe liver damage is rare, lasting for a short time.…”