Prognostic Potential of Liver Enzymes in Patients With COVID-19 at the Leishenshan Hospital in Wuhan.

Zeming Liu,Yan Gong,Di Hu,Meng Wu,Qing Xia,Yihui Huang,Meilin Yi,Zhengwei Li,Liang Guo,Qian Wu,Jinpeng Li,Xiaohui Wu

doi:10.3389/fcimb.2021.636999

Abstract

BackgroundCoronavirus disease 2019 (COVID-19) has evolved into a pandemic. We hypothesized that biochemical indicators of liver function may help determine the prognosis of COVID-19 patients.MethodsPatient information was collected from the Wuhan-Leishenshan hospital. Logistic and Cox regression analyses, Kaplan-Meier curves, and Curve fitting were used to determine the correlation between elevated levels of aspartate transaminase (AST), alanine transaminase (ALT), and AST/ALT and severity of disease/mortality.ResultsLogistic and Cox regression analyses and Kaplan-Meier survival curves showed that COVID-19 progression correlated with elevated levels of AST and AST/ALT. The odds ratios for elevated levels of AST and AST/ALT in patients were 0.818 (95% confidence interval [CI]: 0.274-2.441, P = 0.035) and 2.055 (95% CI: 1.269-3.327, P = 0.003), respectively; the hazard ratios were 4.195 (95% CI: 1.219-14.422, P = 0.023) and 3.348 (95% CI: 1.57-7.139, P = 0.002), respectively. The Kaplan-Meier survival curves demonstrated that patients with elevated AST and AST/ALT levels had a higher risk of developing severe COVID-19.ConclusionElevated AST and AST/ALT levels correlated with severity of COVID-19 and mortality. Liver function tests may help clinicians in determining the prognosis of patients undergoing treatment for COVID-19.

Highlights

Coronavirus disease 2019 (COVID-19) has evolved into a pandemic
This study was approved by the Research Ethics Commission of the Zhongnan Hospital, Abbreviations: COVID-19, coronavirus disease; AST, aspartate transaminase; ALT, alanine transaminase; CI, confidence interval; CT, computed tomography; SD, standard deviation; IQR, median and interquartile range; Angiotensinconverting enzyme 2 (ACE2), angiotensinconverting enzyme 2; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2
Patients with normal and elevated levels of AST were of similar age

Summary

Introduction

Coronavirus disease 2019 (COVID-19) has evolved into a pandemic. We hypothesized that biochemical indicators of liver function may help determine the prognosis of COVID-19 patients. Since its first reported occurrence in Wuhan, coronavirus disease 2019 (COVID-19) has become an alarming cause of morbidity and mortality worldwide This can be attributed to the median incubation time, ranging from 4 to 7 days, between SARS-CoV-2 infection and the appearance of symptoms. About 14-53% of patients with COVID-19 were reported to hepatic dysfunction, in those with severe disease (Jothimani et al, 2020) Considering these contradictory findings, it is imperative to determine the effect of liver function in the pathogenesis of COVID-19. We aimed to examine the correlation between prognosis of patients with COVID-19 and aspartate transaminase (AST), alanine transaminase (ALT), and AST/ALT levels This will help elucidate the role of impaired liver function in the progression of COVID-19 and devise novel therapeutic strategies for clinical intervention

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