COVID-19 caused from the Coronaviridae family is one of the most crucial health issue faced by the world currently. Due to the presence of this novel corona virus, there is a dearth of data regarding the knowledge about the disease, and extent of liver involvement is debatable.

The present study is aimed to evaluate the laboratory investigations of COVID-19 patients highlighting the importance of liver enzymes and its correlation with outcomes.

The present study recruited 93 patients with COVID-19 and 186 people from the normal population Cohort. The laboratory investigations included CBC, aspartate Aminotransferase (AST), alanine Aminotransferase (ALT), alkaline Phosphatase (ALP), direct bilirubin, and total bilirubin. The outcome measures obtained from lab results involved lengths of hospital stay, critical care transfers, and deaths.

The results showed that counts of lymphocytes (833.3 ± 564.4 vs. 2465.1 ± 796.6 per mm³) and platelets (209.4 ± 62.7 vs. 255.2 ± 63.8 per mm³) were remarkably lower in patients in contrast to controls. Also, AST (39.5 ± 34.9 vs. 19.9 ± 7.5 U/L), ALT (40.4 ± 46.5 vs. 21.6 ± 12.7 U/L), and ALP (192.6 ± 91.2 vs. 222.2 ± 70.6 U/L) were higher in patients than in controls. Raised direct bilirubin (45.8%), ALT (30.3%), AST (29.2%), ALP (17%), and total bilirubin (10.2%), in sequence were the most frequent hepatic impairment events. The risk of transfer to intensive and critical care units was substantially related to elevated levels of AST and direct bilirubin. AST = 30.5 (U/L) had a sensitivity of 71.4% and specificity of 68.5% for critical and intensive care transfer. The death rate remarkably increased with increased AST levels.

Therefore, the study concluded that abnormal liver enzymes are common findings in patients with COVID-19. It can also be postulated that AST is not always suggestive for liver damage, its raised values can also be attributed to the systemic inflammation induced by the virus.

Source: Omrani-Nava V , Maleki I, Ahmadi A , Moosazadeh M , Hedayatizadeh-Omran A , et al. Evaluation of Hepatic Enzymes Changes and Association with Prognosis in COVID-19 Patients. Hepat Mon. 2020 ; 20(4):e103179.