Abstract
BackgroundCoronavirus disease 2019 (COVID-19) pandemic has become the most severe global health issue. Abnormal liver functions are frequently reported in these patients. However, liver function abnormality was often overlooked during COVID-19 treatment, and data regarding liver functions after cure of COVID-19 is limited. This study aimed to reveal the changes of liver function tests (LFTs) during hospitalization, and its clinical significance in patients with COVID-19.MethodsIn this retrospective, bi-center study, a total of 158 hospitalized patients diagnosed with COVID-19 in China were included from January 22nd, 2020 to February 20th, 2020. Clinical features, laboratory parameters including LFTs, and treatment data were collected and analyzed. LFTs included alanine transaminase, aspartate aminotransferase, alkaline phosphatase, gamma-glutamyl transferase, and total bilirubin. Patients were considered with abnormal LFTs when any value of these tests was higher than upper limit of normal.ResultsOf 158 patients with COVID-19, 67 (42.41%) patients had abnormal LFTs on admission and another 50 (31.65%) patients developed abnormal LFTs during hospitalization. The incidence of LFTs abnormality in severe COVID-19 cases was significantly higher than non-severe cases. All LFTs in COVID-19 patients were correlated with oxygenation index. There was no statistical difference in treatment between the patients with or without liver test abnormalities. By the time of discharge, there were still 64 (40.50%) patients with abnormal LFTs. Logistic regression analysis identified younger age, hypertension and low lymphocyte counts as independent risk factors for persistent abnormal LFTs during hospitalization.ConclusionLiver function tests abnormality was common in COVID-19 patients and was more prevalent in severe cases than in non-severe cases. A substantial percentage of patients still had abnormal LFTs by the time of discharge.
Highlights
The coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has posed a serious threat to the global public health (Zhu et al, 2020)
Though our data did not conform with the typical biochemical behavior of hypoxic hepatitis, we found that all liver function indexes, including alanine transaminase (ALT), AST, total bilirubin (TB), alkaline phosphatase (ALP), and gamma-glutamyl transferase (GGT), were significantly correlated with the oxygenation index
Future study with larger population and longer follow-up period are needed to investigate the mechanism and outcome of liver function abnormalities. In this bi-center retrospective study, liver function tests (LFTs) abnormality was common in COVID-19 patients and was more prevalent in severe cases than in non-severe cases
Summary
The coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has posed a serious threat to the global public health (Zhu et al, 2020). Previous studies suggested that patients with abnormal liver tests had significantly higher odds of developing severe pneumonia, and medication such as lopinavir/ritonavir may increase the risks of liver injury (Bloom et al, 2020; Cai et al, 2020).a surveillance of liver function change and outcome of COVID-19 patients is necessary. The clinical significance, underlying mechanisms and changes of liver function abnormality during hospitalization and its risk factors in COVID-19 patients are still unclear. This study aimed to reveal the changes of liver function tests (LFTs) during hospitalization, and its clinical significance in patients with COVID-19
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