Assessment of Liver Function and Its Correlation with Inflammatory Markers and Severity of Disease during COVID-19 Second Wave in a Tertiary Care Centre

Abstract

Aims: To assess the Liver function in COVID-19 infection and study its correlation with inflammatory markers and severity of disease.
 Study Design: A Retrospective Observational study.
 Place and Duration of Study: Government Kilpauk Medical College, Chennai, India. Two month study period was taken during the second COVID wave (1st May 2021 to 30th June 2021).
 Methodology: The study covered all COVID-19 positive individuals who were over the age of 19. Patients with any chronic liver disease, Hepatitis B or Hepatitis C were excluded. Data was collected from case files. Record was made of the liver function tests and inflammatory markers – C-Reactive Protein and Interleukin-6 (CRP, IL-6). Severe disease was defined as patients with respiratory rate > 30/min, SpO2 <90% on room air or requiring Intensive Care Unit (ICU) admission or mechanical ventilation. Collected data was analysed using appropriate statistical tests.
 Results: 132 patients were included in the study. Out of these 59 patients (44.70%) had elevated Liver function tests (LFTs). Maximum patients (42.37%) had hepatocellular pattern. 59.32% patients were males. Mean age of patients with elevated LFTs was 51.03±13.03 years. ICU admission was required in 40.68% of patients with deranged LFTs compared to 23.28% in patients with normal LFTs, which was statistically significant (P <0.03). A positive correlation was found between deranged LFTs and inflammatory markers (CRP, IL-6). (P <0.001).
 Conclusion: A significant number of COVID-19 positive individuals have abnormal liver function. Inflammatory indicators and elevated LFTs have a positive relationship. Patients with abnormal liver function tests were more likely to have severe illness.