The Association of Liver Enzymes with Disease Severity in PCR positive COVID-19 Patients

Abstract

Introduction: This study aimed to examine the relationship between liver enzymes and severity of COVID-19. Furthermore, patients with clinical diagnosis (PCR negative) and patients with definitive laboratory diagnosis (PCR positive) of COVID-19 were compared in terms of disease severity. Method: This cross-sectional study enrolled 158 patients with COVID-19 admitted based on chest CT scan findings to the COVID-19 ward of Shahid Mohammadi Hospital, affiliated with Hormozgan University of Medical Sciences (Iran).Reversetranscriptase polymerase chain reaction (RT-PCR) test was performed for all the patients, who were accordingly divided into groups of PCR negative COVID-19 with clinical diagnosis, and COVID-19 with definitive laboratory diagnosis. Results: The results indicated a significant elevation of AST (Aspartate transaminase) and Alanine transaminase (ALT) in the PCR positive group compared to the PCR negative group (p = 0.02, p = 0.04, respectively). The results also showed a correlation between AST level and COVID-19 severity (p < 0.01, OR = 2.06). Moreover, a significant correlation was observed between ESR and the levels of AST and ALT (r = 0.24 for AST, r = 0.47 for ALT). Conclusion: AST and ALT significantly increased in the PCR positive group compared to the PCR negative group, and AST was correlated with COVID-19 severity. Furthermore, a significant correlation was observed between ESR and the levels of AST and ALT. Therefore, COVID-19 involves liver both directly and through the inflammatory system.

Levels of Liver Enzymes in Patients with Hydatid Disease

“…The results shown in Table (4) indicate an increase in the ALP level in patients by (7.56±96:33 units/l) compared to the control group, which amounts to (3.19±53.13 units/l). The difference gained statistical significance of less than 0.01, and significant differences appeared for the level of ALP effectiveness in patients with cysts whose size was less than 5 cm (5.33±89.43), compared to patients whose size of cysts was greater than 5 cm (9.29±132.1 units).…”

“…The statistical analysis showed that there were significant differences in the level of the ALT enzyme in patients by (0.44± 16.51 U/L), compared to the control group, which was equal to (0.17± 7.712 U/L) as indicated in Table (4). It was also concluded that There are significant differences in the activity of the enzyme with a probability score of less than 0.05 when comparing patients with cysts with a size of 5 cm (0.71± 13.72 units/l) and patients with cysts with a size larger than 5 cm (0.39± 16.71 units/l) as indicated in the table (5).…”

“…The results shown in Table (4) indicate that there are significant differences with a probability ratio greater than 0.05 in the effectiveness of the AST enzyme in patients (0.43± 14.291units/l). The statistical analysis of the results showed that there is a significant difference between patients with cysts of size less than 5 cm (0.22± 8.341units/l) and among patients with cysts larger than 5 cm with a probability of less than 0.05, as indicated in the table below (4).…”

“…The results shown in Table (4) indicate that there are significant differences with a probability ratio greater than 0.05 in the effectiveness of the AST enzyme in patients (0.43± 14.291units/l). The statistical analysis of the results showed that there is a significant difference between patients with cysts of size less than 5 cm (0.22± 8.341units/l) and among patients with cysts larger than 5 cm with a probability of less than 0.05, as indicated in the table below (4). The results also showed that there were significant differences when comparing patients with a primary infection with a rate of (0.53± 15.31) units/liter compared to patients with a secondary infection that had a rate of (0.56± 13.29) units/liter Table (6).…”

“…The life cycle of Echinococcus include a definitive host, often canines, an intermediate host, which may include sheep, goats, or cattle, and sometimes an accidental host, namely humans. According to available reports, the prevalence of E. granulosus infection among domestic dogs in Iraq is estimated to range from around 2% to 5% (4) .…”