Abstract
Background and Aims: Recent reports have indicated that hepatic dysfunction occurred in a proportion of patients with coronavirus disease 2019 (COVID-19). We aimed to compare and describe the liver biomarkers in different subtypes of COVID-19 patients.Methods: This study enrolled 288 COVID-19 patients in Huangshi Hospital of Traditional Chinese Medicine. All patients were divided into ordinary, severe, and critical groups according to the Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia (Trial Version 7). Demographic, clinical characteristics and liver biomarkers were compared among the three groups.Results: During hospitalization, AST, TBiL, and ALP levels in ordinary and severe patients fluctuated within the normal range with a rising trend in critical patients except AST. ALT and GGT levels fluctuated within the normal range showing an upward trend, while LDH levels in the critical group exceeded the normal range. Prealbumin showed an upward trend, especially in the severe group. At discharge, AST and LDH levels in ordinary and severe groups were lower than their baselines but increased in the critical group. In contrast to albumin, TBiL levels were increased in ordinary and critical groups while decreased in the severe group. The stratified analysis revealed factors affecting liver function in critical cases included highest temperature ≥38.0°C, age ≥60 and symptom of hypoxemia.Conclusions: COVID-19 can cause severe hepatic dysfunction in critical patients, requiring early monitoring and intervention. LDH, ALP, GGT, TBiL, prealbumin, and albumin may be helpful for evaluating and predicting disease prognosis due to their correlation with disease severity in COVID-19.
Highlights
Since December 2019, a pneumonia of unknown cause broke out in Wuhan
According to the Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia (Trial Version 7) [10], COVID-19 patients were confirmed by positive real-time reverse transcriptase-polymerase chain reaction (RT-PCR) and chest computed tomography (CT) test
The degrees of COVID-19 infection were categorized into ordinary, severe, and critical based on Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia (Trial Version 7) [10]
Summary
Since December 2019, a pneumonia of unknown cause broke out in Wuhan. Epidemiological evidence shows that this pneumonia can spread among people through close contact and respiratory droplets, and people are generally susceptible [1,2,3]. Different from severe acute respiratory syndrome (SARS) and middle east respiratory syndrome coronavirus (MERS) [4], a novel coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was identified as the pathogen. This unique pneumonia was named coronavirus disease 2019 (COVID-19) by World Health Organization (WHO). Common clinical manifestations of SARS-CoV-2 infection include fever, fatigue and dry cough [5,6,7,8,9]. Recent reports have indicated that hepatic dysfunction occurred in a proportion of patients with coronavirus disease 2019 (COVID-19). We aimed to compare and describe the liver biomarkers in different subtypes of COVID-19 patients
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