ALT and AST- New Prognostic Markers of COVID-19 in India

Abstract

Introduction: The second wave of the COVID-19 pandemic has affected India ruthlessly, and high mortality has been observed in all age groups. The city of Lucknow was severely affected, and many patients were admitted to our hospital during the second wave, which occurred from April to May 2021. In the present study, we investigated the association between the level of ALT (Alanine Aminotransferase) and AST (Aspartate Aminotransferase) with the other biomarkers (serum CRP, ferritin, and D-dimer) COVID-19 patients’ mortality.
 Method: Clinical and laboratory data from 80 consecutive cases meeting inclusion criteria were obtained from the records of patients with SARS Cov-2 infection admitted to Neuro ICU Medanta Hospital Lucknow. Patients were divided into two groups. The first group had data from patients who were discharged (control group), and the second group had data from patients who succumbed to death (case group). The data was analyzed by independent-sample t-test using IBM SPSS Statistics Version 20 software.
 Result: It was observed that clinical features and co-morbidity were similar in both groups except for diabetes, which was more prevalent in the deceased group (p 0.01). A study of investigated biomarker levels (CRP, FERRITIN, D-DIMER, ALT, AST) in two groups revealed that raised ALT and AST levels (> 1000 u/l) were very frequent in the deceased group and the difference was statistically very significant ALT (P< 0.001), AST (P<0.005). A similar pattern was found in other biomarkers. So ALT and AST > 1000 u/L can be used as biomarkers for high mortality. It is economical, easy to perform, and widely available too.