Liver Function Status in COVID-19: An Indian Perspective

In SARS-CoV2 infection multi-organ involvement of heart, kidney pancreas and liver are reported. Most studies suggest that though mild derangements of liver function may be experienced by most COVID-19 patients but significant liver injury is not common. The aim of this study was to describe clinical characteristics of COVID-19 patients admitted to this level 4 COVID hospital and find out their relation to the liver parameters.

COVID-19 patients admitted in this level -4 COVID hospital during the study period were classified as mild (Group 1,n=42), moderate (Group 2,n=40) and severe (Group 3,n=35) cases as per national guidelines. Serum samples were analyzed using biochemistry autoanalyzer. Serum levels of total and direct bilirubin, Alanine Transaminase (ALT) and Aspartate Transaminase (AST), Alkaline Phosphatase (ALKP), total protein and albumin were assayed.

Patients with higher BMI (Body mass index) had developed greater COVID-19 related complications and hence had to be admitted either in HDU (Group 2) or in ICU (Group 3) set up. Total and direct serum bilirubin levels were normal and almost similar in the various study groups. The primary liver enzymes ALT and AST were raised in the entire study population. However differences between the study groups were statistically insignificant. ALKP was within normal reference range for all the cases. Serum total Protein levels were within normal physiological limits in all the three groups. However serum albumin levels were reduced significantly in Groups 3 and 2 in comparison to Group 1.

Derangements of LFT in COVID-19 Patients are common especially in patients with severe disease but its long term impact is unknown. Hence, further investigation and long term follow up of recovered COVID-19 cases is warranted to understand the pathophysiology and implication of liver injury that occurs both in overt and covert forms during infection.