A Reliable Prognostic Marker for Liver Dysfunction in COVID-19 Infection

Area of Science:

• Hepatology
• Infectious Diseases
• Critical Care Medicine

Background:

• COVID-19, originating in late 2019, rapidly became a global pandemic with significant mortality.
• Abnormal liver function tests are observed in a subset of patients diagnosed with COVID-19.

Purpose of the Study:

• To investigate the clinical significance of liver chemistries in patients diagnosed with COVID-19.
• To determine the association between abnormal liver function tests and patient outcomes, including survival and intensive care unit (ICU) admission.

Main Methods:

• A cross-sectional study involving 1044 consecutive COVID-19 patients was conducted in Tehran, Iran.
• Diagnosis was confirmed via clinical criteria, chest computed tomography (CT) scans, and nucleic acid testing.
• Associations between liver enzymes, function tests, and outcomes (survival, ICU admission, fatty liver on CT) were evaluated.

Main Results:

• Elevated alanine transaminase (ALT) levels were noted in 495 patients; fatty liver disease was present in 38.1% of those with CT scans.
• Bilirubin, albumin, partial thromboplastin time (PTT), C-reactive protein (CRP), and triglyceride levels were significantly associated with ICU admission and mortality.
• Prothrombin time (PT), platelet count, low-density lipoprotein (LDL), fasting blood sugar (FBS), and pH were correlated with mortality and ICU admission.

Conclusions:

• Liver function tests serve as accurate predictors of a poorer prognosis in COVID-19 patients.
• While liver enzymes showed slight elevations in non-survivors or ICU patients, they were not linked to fatty liver changes observed on CT scans.