Elevated liver enzymes and covid-19 prognosis in hospitalized patients

Abstract

COVID-19 was first reported as a viral pneumonia of unknown cause. Gradually, it became clear that this disease can have multi-organ involvement and show several consequences. In this study, we focused on whether the increase in liver enzyme levels in hospitalized patients with a definitive diagnosis of COVID-19 can be considered as a criterion for differentiating individuals with different prognosis in the course of the disease or not. Purpose: Can increased levels of liver enzymes in patients admitted with a definitive diagnosis of COVID-19 be considered as a criterion for differentiating individuals with different prognosis in the course of the disease or not? Method: 1017 patients whom diagnosed as Covoid-19 with PCR test or compatible clinical signs and imaging admitted to Imam Reza Hospital of Tabriz assessed. Liver enzyme (AST, ALT) levels at the day of admit, CURB 65, qSOFA, ICU care, mechanical ventilation and death were compared among three groups (normal subjects, elevated liver enzyme levels up to 3 folds of upper limit normal, liver injury as liver enzyme levels more than 3 folds of upper limit normal) Results: 1017 patients participated in this study. The mean age of the patients was 62.58 ± 17.45 years and 562 (55.4%) patients were male and 455 (44.6%) were female. 301 (29.59%) of patients had impaired liver tests and 23 (4.1%) of patients had liver injury. 208 patients had CURB65>2 whom 41 patients were in impaired liver enzyme levels group and 8 patients had liver injury. According to collected data 37 patients had qSOFA>1 whom 14 patients grouped in elevated liver enzyme levels and 2 patients in injured liver group. Among 41 patients who needed mechanical ventilation 13 patients had elevated liver enzyme levels and 7 patients had liver injury. Among 273 patients who admitted in ICU 94 16. 170 54 11. -19 (0.05).