Elevated serum aspartate aminotransferase level identifies patients with coronavirus disease 2019 and predicts the length of hospital stay.

Xuexiang Gu,Xusheng An,Shufeng Yang,Honggang Wang,Xiaozhong Yang,Xiangyu Li,Shangnong Wu

doi:10.1002/jcla.23391

Abstract

BackgroundCoronavirus disease 2019 (COVID‐19) has become a worldwide public health emergency. This study aimed to investigate the clinical significance of liver blood tests in COVID‐19 patients.MethodsThe analysis included clinical data of 23 patients with suspected COVID‐19 and 66 patients with confirmed COVID‐19 from January 25 to February 20, 2020. The relationship between liver blood test results, liver condition (HBsAb positive, HBcAb positive, and fatty liver disease), and duration of hospital stay among COVID‐19 patients was analyzed.ResultsThe median hospital stay of COVID‐19 patients was 6 days. Serum albumin (Alb) level was lower in patients with COVID‐19 confirmed on admission than in patients with suspected COVID‐19 (40.08 g/L vs 42.50 g/L, P = .016), while the level of aspartate aminotransferase (AST) was higher (23 U/L vs 18 U/L, P = .005). Abnormal results of liver blood tests in patients with COVID‐19 included increased levels of alanine transaminase (ALT) (21.2%, 14 patients), AST (15.2%, 10 patients), and gamma‐glutamyl transpeptidase (GGT) (22.7%, 15 patients). After 5‐10 days of treatment, levels of Alb and AST in COVID‐19 patients were significantly decreased (P < .001 and P = .027, respectively). Abnormal levels of Alb and AST in patients with COVID‐19 were not associated with the liver condition (all P > .05). In addition, only levels of AST were positively correlated with the duration of hospital stay (r = .334, P = .007).ConclusionAbnormal results of the liver blood test were found in COVID‐19 patients. The COVID‐19 patients on admission with the higher levels of AST might have longer hospital stays.

Highlights

Several cases of pneumonia of an unknown etiology were detected in Wuhan, Hubei Province, China, in December 2019, and currently, an increasing number of countries face the challenge of the ensuing pandemic
Recent studies have documented that severe acute respiratory syndrome (SARS)-CoV-2 can be detected in fecal samples, and some patients with COVID-19 are positive for the anal swab test.[10,13]
The overall occurrence of diarrhea in COVID-19 was 5.8% (145/2506).[5]. These findings indicate that SARS-CoV-2 may affect the digestive system

Summary

Introduction

Several cases of pneumonia of an unknown etiology were detected in Wuhan, Hubei Province, China, in December 2019, and currently, an increasing number of countries face the challenge of the ensuing pandemic. There are more than 1 353 361 confirmed cases of the disease in more than 200 countries, and the number of deaths exceeds 79 235 as of April 8, 2020.1 On February 11, 2020, the disease was named COVID-19, and the responsible virus was named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).[2,3]. The relationship between liver blood test results, liver condition (HBsAb positive, HBcAb positive, and fatty liver disease), and duration of hospital stay among COVID19 patients was analyzed. Abnormal results of liver blood tests in patients with COVID-19 included increased levels of alanine transaminase (ALT) (21.2%, 14 patients), AST (15.2%, 10 patients), and gammaglutamyl transpeptidase (GGT) (22.7%, 15 patients). The COVID-19 patients on admission with the higher levels of AST might have longer hospital stays

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