S3249 Abnormal Liver Function Tests in Patients Presenting With COVID-19

Abstract

INTRODUCTION: Recent studies from China reported have reported various rates of abnormal liver function tests in patients hospitalized with COVID-19 infection. However, data from the United States is limited. We sought to evaluate abnormalities in liver function tests (LFTs) in patients presenting with COVID-19 in the United States and compared them to a control group of hospitalized patients tested negative for COVID-19. METHODS: Patients with confirmed COVID-19 infection at our institution between January and March of 2020 were included. Patients who were suspected to have COVID-19 but tested negative served as controls. Information regarding patient demographics and laboratory values was recorded. RESULTS: A total of 139 patients with COVID-19 and 131 were controls were included. There was no difference between COVID-19 patients and controls in age (67.4 years versus 67.8 years, P = 0.8) or gender (female: 46% versus 59.4%, P = 0.5). Upon presentation, LFTs were abnormal in 44.9% of COVID patients compared to 35.8% controls (P = 0.12) There was no difference in the proportion of patients with elevated total bilirubin and international normalized ratio (INR) among COVID patients and controls. A higher proportion of COVID patients than controls had abnormal serum Alanine Aminotransferase (ALT) (27.9% versus 16.5%, P = 0.02) and serum Aspartate Aminotransferase (AST) levels (41.8% versus 22.1%, P < 0.001). A lower proportion of COVID patients had abnormal serum alkaline phosphatase (ALP) levels (10% versus 22.7%, P = 0.005) as compared to controls [Table 1]. Elevation in ALT and AST greater than 3 times the upper limit of normal was only seen in 5 COVID-19 patients. CONCLUSION: Abnormal LFTs are common on presentation in COVID-19 patients. However, the liver injury is predominantly mild and hepatocellular. Synthetic liver dysfunction is uncommon in COVID-19 patients.Table 1.: Proportion with elevated liver function tests in COVID patients and controls