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Updated: Oct 3, 2025

Human Liver Microphysiological System for Assessing Drug-Induced Liver Toxicity In Vitro
Published on: January 31, 2022
COVID-19 and Liver Dysfunction
Nour Ibrahim1, Jad Hosri1, Yara Bteich1
1General Medicine, Faculty of Medical Sciences, Lebanese University, Beirut, LBN.
Insights
Abnormal liver function tests, including aspartate aminotransferase (AST) and alkaline phosphatase (ALP), are linked to severe COVID-19 outcomes. Early identification of these liver enzyme abnormalities can help predict disease severity in hospitalized patients.
Area of Science:
- Hepatology
- Infectious Diseases
- Clinical Medicine
Background:
- The COVID-19 pandemic has strained global healthcare systems, necessitating methods for patient stratification.
- Liver enzyme abnormalities are increasingly recognized in COVID-19 patients, but their prognostic value requires further investigation.
Purpose of the Study:
- To investigate the association between liver function tests (LFTs) and clinical outcomes in hospitalized COVID-19 patients in Lebanon.
- To identify potential confounding factors influencing this relationship.
Main Methods:
- A retrospective cohort study involving 230 COVID-19 patients hospitalized between December 2020 and March 2021.
- Analysis of liver function tests (LFTs) and other laboratory values at admission and peak hospitalization using SPSS.
Main Results:
- Prevalence of abnormal LFTs in severe COVID-19: AST 77%, ALT 49%, ALP 12%, GGT 37%.
- Abnormal AST, ALP, and GGT levels at admission were significantly associated with severe COVID-19 infection (p < 0.05).
- No significant relationship was found between peak AST levels and treatments received.
Conclusions:
- Abnormal liver function tests upon admission may serve as an early indicator of severe COVID-19 disease.
- Identifying reliable predictors for severe COVID-19 outcomes is crucial for resource management during the pandemic.
Abstract:
Introduction The pandemic of coronavirus disease 2019 (COVID-19) has caused over four million deaths, depleting resources and healthcare workers; therefore, in an attempt to stratify patients, the relationship between liver enzymes and clinical outcome was studied. This study aimed to assess the pattern and impact of liver enzymes on the clinical outcome of hospitalized patients with COVID-19 in Lebanon and look for possible confounding factors. Methodology This was a single-centered retrospective cohort study conducted between December 2020 and March 2021 on 230 patients diagnosed with COVID-19. Liver function tests (LFTs) and other laboratory values on admission and peak hospitalization were analyzed using SPSS. Results The prevalence of abnormal liver tests among the sample population with severe COVID-19 infection were as follows: aspartate aminotransferase (AST), 77%; alanine aminotransferase (ALT), 49%; alkaline phosphatase (ALP), 12%; and gamma-glutamyl transferase (GGT), 37%. A severe COVID-19 infection was more likely present in patients with abnormal levels of AST (p = 0.015), ALP (p = 0.03), and GGT (p = 0.022). ANOVA test revealed no significant relationship between AST levels at peak hospitalization and the treatments received by the patient. Conclusion Abnormal liver function tests of patients at admission may be an indicator of more severe disease. In the context of scarce resources created by the pandemic, it becomes essential to establish a reliable predictor for a severe outcome of COVID-19 infection and manage accordingly.
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