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The clinical implication of gamma-glutamyl transpeptidase in COVID-19
Jianrong Liu1,2, Chao Yu3,4, Qing Yang1,5
1Department of Hepatic Surgery and Liver Transplantation Center, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Insights
Elevated gamma-glutamyl transferase (GGT) levels are common in severe COVID-19 cases and indicate a higher risk of prolonged hospital stay. GGT may serve as a biomarker for SARS-CoV-2 infection susceptibility.
Area of Science:
- Hepatology
- Virology
- Pulmonology
Background:
- Coronavirus disease 2019 (COVID-19) primarily affects the respiratory system, but its impact on other organs like the liver is not fully understood.
- Investigating the hepatobiliary system's response to COVID-19 is crucial for a comprehensive understanding of the disease.
Purpose of the Study:
- To investigate the effects of COVID-19 on the hepatobiliary system.
- To evaluate the correlation between gamma-glutamyl transferase (GGT) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) entry receptor angiotensin-converting enzyme 2 (ACE2).
Main Methods:
- Clinical records and laboratory results from 66 COVID-19 patients were analyzed.
- Bioinformatics analysis was performed to assess the relationship between GGT and ACE2.
Main Results:
- Over 50% of patients exhibited abnormal liver function upon admission, particularly males and those with diabetes.
- Elevated direct bilirubin and GGT levels were observed in severe pneumonia cases.
- Increased GGT and AST levels correlated with longer hospital stays.
- ACE2 expression was linked to GGT via the shared transcriptional regulator HNF1B.
Conclusions:
- Elevated GGT levels are prevalent in severe COVID-19 cases and correlate with disease severity and prolonged hospitalization.
- GGT is a potential biomarker for predicting SARS-CoV-2 infection susceptibility due to its consistent expression with ACE2.
Background And Aim:
Coronavirus disease 2019 (COVID-19) is a life-threatening disease that predominantly causes respiratory failure. The impact of COVID-19 on other organs remains elusive. Herein, we aimed to investigate the effects of COVID-19 on the hepatobiliary system.
Methods:
In the current study, we obtained the clinical records and laboratory results from 66 laboratory-confirmed patients with COVID-19 at the Wuhan Tongji Hospital between 10 February 2020 and 28 February 2020. The detailed clinical features and laboratory findings were collected for analysis. Bioinformatics analysis was conducted to evaluate the correlation between gamma-glutamyl transferase (GGT) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) entry receptor angiotensin-converting enzyme 2 (ACE2).
Results:
In this cohort, 30 (51.7%) patients had abnormal liver function on admission, which was associated with disease severity and enriched in the male and diabetic patients. The elevated levels of direct bilirubin (P = 0.029) and GGT (P = 0.004) were common in patients with severe pneumonia when compared with those with mild pneumonia. In addition, elevated levels of GGT (P = 0.003) and aspartate aminotransferase (AST) (P = 0.007) were positively associated with longer hospital stay. The expression of ACE2 was closely associated with GGT in various human tissues because they shared the common transcriptional regulator hepatic nuclear factor-1β (HNF1B).
Conclusions:
Increased GGT levels were common in severe cases and elevated GGT levels were positively associated with prolonged hospital stay and disease severity. Due to the consistent expression with ACE2, GGT is a potent biomarker indicating the susceptibility of SARS-CoV-2 infection.
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