There have been increasing reports that some patients with SARS-CoV-2 infection have abnormal liver function. Fan and colleagues, therefore, conducted a study at the Shanghai Public Health Clinical Center, Shanghai, China, to determine the features of COVID-19-related liver damage.

This retrospective, single-center study included 148 consecutive patients with confirmed COVID-19 from January 20 to January 31, 2020, with 73 females and 75 males; mean age, 50 years. Patient outcomes were followed till February 19, 2020. Investigators analyzed the clinical features, laboratory parameters, including liver function tests, medications, and length of hospital stay. Abnormal liver function was defined as elevated alanine and aspartate aminotransferase, gamma glutamyltransferase, alkaline phosphatase, and total bilirubin.

Overall, 55 patients (37.2%) reported abnormal liver function at hospital admission; 14.5% of these patients had high fever (14.5%), compared with 4.3% of patients with normal liver function. It was noted that patients with abnormal liver function were more likely to be male, and have higher levels of procalcitonin and C-reactive protein. No statistical difference was evident between the groups in medications taken before hospitalization. A significantly higher number of patients with abnormal liver function (57.8%) received lopinavir/ritonavir after admission compared to patients with normal liver function (31.3%). Patients with abnormal liver function also had longer mean hospital stay of 15.09±4.79 days compared to patients with normal liver function (12.76±4.14 days).

It was concluded that over a third of patients admitted to the hospital with SARS-CoV-2 infection were found to have abnormal liver function. Abnormal liver function was also associated with longer hospital stay. Furthermore, a significantly higher proportion of patients with abnormal liver function were given lopinavir/ritonavir after admission. It is important to note that these drugs should be given with caution.

Source: Fan Z, Chen L, Li J, et al. Clinical Features of COVID-19-Related Liver Damage. Clin Gastroenterol Hepatol. 2020 Apr 10.