Changes in Serum Liver Function for Patients with COVID-19: A 1-Year Follow-Up Study

Area of Science:

• Hepatology
• Infectious Diseases
• Post-COVID Conditions

Background:

• COVID-19 is associated with liver injury during hospitalization.
• Long-term liver function post-discharge in COVID-19 patients remains understudied.

Purpose of the Study:

• To analyze the prevalence and characteristics of abnormal liver function one year after COVID-19 hospital discharge.
• To identify risk factors associated with persistent abnormal liver function.

Main Methods:

• Prospective analysis of serum liver function tests (ALT, AST, ALP, GGT, TB) at multiple time points: hospitalization (T1), pre-discharge (T2), 2 weeks post-discharge (T3), and 1 year post-discharge (T4).
• Definition of abnormal liver function based on exceeding upper limits of reference ranges for key liver enzymes and bilirubin.
• Multivariate logistic regression to identify risk factors for abnormal liver function at one year.

Main Results:

• At one year post-discharge (T4), 28.8% of COVID-19 patients exhibited abnormal liver function.
• The proportion of patients with abnormal liver function increased from 32.2% at T1 to 54.8% at T3, with a decrease to 28.8% at T4.
• Elevated ALT at admission was a significant risk factor (OR=2.041, P=0.012) for abnormal liver function at one year, with GGT and TB elevations being common manifestations.

Conclusions:

• Abnormal liver function can be a persistent condition in COVID-19 survivors, extending up to one year post-discharge.
• Dynamic, long-term monitoring of liver function is crucial for managing COVID-19 patients.
• Admission ALT levels may indicate a higher risk for sustained liver function abnormalities post-COVID-19.