Effect of COVID-19 on Liver Enzymes in Hospitalized COVID-19 Patients in the Gaza Strip: A Retrospective Study

Abstract

In severe cases, the novel coronavirus disease 2019 (COVID-19) can cause respiratory failure and multiple organ dysfunction, including liver injury. This study assessed the COVID-19 effect on liver function among hospitalized COVID-19 patients. Three-hundred and seventy patients were recruited. Patients were distributed as the following: control group (n=100), intensive care unit (ICU) hospitalized COVID-19 patients (n=140), and non-ICU hospitalized COVID-19 group (n=130). Data about the levels of liver enzymes were collected from the hospital medical records of the participants. Our results showed a significant increase in alanine aminotransferase (ALT) levels among the ICU hospitalized COVID-19 patients compared with the non-ICU hospitalized COVID-19 patients (p-value <0.01) and the controls (p-value <0.001). Aspartate aminotransferase (AST) concentration significantly increased among the ICU-hospitalized COVID-19 group compared with the non-ICU hospitalized COVID-19 group (p-value <0.01) and the controls (p-value <0.05). The ICU-hospitalized COVID-19 patients had a higher increase in alkaline phosphatase (ALP) levels compared to the non-ICU hospitalized COVID-19 patients and controls (p values <0.001). Based on ALT, AST, and ALP levels, we found that 73 (52%), 77 (55%), and 38 (27%) of the ICU hospitalized COVID-19 patients developed a liver injury. Of those, 12 (8.5%) died compared to 5 (3.5%) patients with abnormal liver function. In conclusion, these findings suggest that COVID-19 disease is associated with abnormal liver function and liver injury.