Clinical Predictors for Abnormal ALT in Patients Infected with COVID-19-A Retrospective Single Centre Study

Area of Science:

• Hepatology
• Infectious Diseases
• Critical Care Medicine

Background:

• Abnormal liver tests, particularly elevated alanine aminotransferase (ALT), are linked to adverse clinical outcomes in COVID-19 patients.
• Identifying simple clinical predictors of abnormal ALT can aid in risk stratification and management.

Purpose of the Study:

• To identify simple clinical predictors of abnormal alanine aminotransferase (ALT) in hospitalized COVID-19 patients.
• To understand the association between abnormal ALT and clinical outcomes in COVID-19.

Main Methods:

• Retrospective observational study including 163 hospitalized COVID-19 patients with normal baseline ALT and at least two subsequent ALT measurements.
• Data collected included demographics, clinical characteristics, and biochemical laboratory tests.
• Multivariate logistic regression was used to identify independent risk factors for abnormal ALT.

Main Results:

• 30.7% of patients developed abnormal ALT.
• Independent predictors for abnormal ALT included R-factor ≥1 on admission (aOR 3.13) and hypoxia (aOR 3.54).
• Patients with abnormal ALT experienced more severe illness, requiring more oxygen, ICU/HDU admission, and intubation, though mortality rates were similar.

Conclusions:

• Abnormal liver injury, indicated by elevated ALT, correlates with poor clinical outcomes in COVID-19.
• R-factor ≥1 and hypoxia are significant, independent clinical predictors for developing abnormal ALT in COVID-19 patients.