S3247 Prevailing Patterns of Liver Enzymes in Patients With COVID-19 Infection and Association With Clinical Outcomes

Abstract

INTRODUCTION: Coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) is now a critical threat to global public health. Although, the majority of patients present with respiratory illness, several studies have described multi-organ involvement. The purpose of this study was to report liver enzyme test results in COVID-19 patients on admission and their association with clinical outcomes. METHODS: This study was a single-center retrospective analysis of all in-patients with a confirmed diagnosis of COVID-19. Demographic, clinical factors, and liver enzyme tests including aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were noted from the time of admission. Association of liver enzyme elevation with clinical outcomes such as inpatient death need for intubation and vasopressor use was determined using chi-square test and multivariate regression analysis. RESULTS: Among 200 patients, AST elevation was seen in 55% and ALT elevation in 20% of patients. AST elevation was associated with in-patient death OR 1.03 (95% CI 1.01–1.05) P = 0.035, need for vasopressors CI 1.034 (95% CI 1.015–1.055) P = 0.001 and intubation OR 1.03 (95% CI 1.01–1.05) P = 0.002. AST/ALT ratio of 2 or more was seen in 34% of patients and was associated with the need for intubation OR 2.678 95% CI [1.202–5.963] P = 0.016 and need for vasopressors OR 3.352 95% CI [1.495–7.514]. CONCLUSION: Serum aminotransferase levels are useful markers of hepatocellular injury. Patients with elevated AST, AST/ALT ratio are at higher risk of severe disease as evidence by intubation, vasopressor use, and inpatient death. These patients should be monitored closely given the propensity for severe disease.