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Liver Enzymes Changes and their Association with Outcome in Hospital Inpatients with COVID-19 in Jordan

Tarek Mazzawi1, Hadeel Alshahwan1, Ban Aladamat1

  • 1Department of Internal Medicine, Faculty of Medicine, Al-Balqa Applied University, Salt, Jordan.

Middle East Journal of Digestive Diseases
|September 25, 2025
PubMed

Insights

COVID-19 commonly causes abnormal liver enzymes, particularly aspartate aminotransferase (AST). Elevated AST and alanine aminotransferase (ALT) correlate with poorer outcomes in hospitalized patients.

Area of Science:

  • Hepatology
  • Infectious Diseases
  • Clinical Biochemistry

Background:

  • COVID-19 is associated with abnormal liver enzyme levels, especially in severe cases.
  • Limited regional data exists on the impact of COVID-19 on liver function in Jordan.
  • This study addresses the gap in understanding liver enzyme changes in Jordanian COVID-19 patients.

Purpose of the Study:

  • To investigate liver enzyme alterations in hospitalized COVID-19 patients in Jordan.
  • To determine the association between liver enzyme changes and patient prognosis.
  • To analyze the relationship between liver enzyme abnormalities and clinical outcomes.

Main Methods:

  • Retrospective cohort study of 359 hospitalized COVID-19 patients during the second pandemic wave in Jordan.
  • Collection and statistical analysis of data on liver enzymes, demographics, and outcomes.
  • Inclusion criteria focused on patients admitted to Ministry of Health hospitals.

Main Results:

  • 39.6% of patients exhibited elevated liver enzymes; 5.9% exceeded twice the upper limit of normal (ULN).
  • Aspartate aminotransferase (AST) elevation alone was most common (52.1%), followed by combined AST/alanine aminotransferase (ALT) elevation (40.8%).
  • Older age, male sex, and autoimmune comorbidities were linked to worse prognosis; peak and discharge AST/ALT levels differed significantly.

Conclusions:

  • Liver enzyme abnormalities are frequent in COVID-19 patients, with AST elevation being the most prevalent.
  • Elevated AST and ALT levels are associated with indicators of poorer prognosis, including longer hospital stays, older age, and male sex.
  • Findings highlight the clinical significance of monitoring liver function in COVID-19 management.
Abstract

Keywords:
HepatitisLiver injuryViral infection

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