COVID-19-Related Abnormal Liver Enzymes Levels: A Retrospective Study

Abstract Background: A new disease called Coronavirus disease (COVID-19) related to SARS-CoV-2 has brought serious attacks to the world. It causes damage to multiple organ systems of the body include liver. Here we intend to shed light on the clinical features its mechanism related to liver damage which caused by COVID-19.Methods: Clinical records and laboratory results were obtained from 138 patients with laboratory-confirmed COVID-19 who were admitted to Tongji hospital, Wuhan, China from February 8, 2020 to February 18, 2020. Information on clinical features of patients with abnormal liver tests were collected for analysis.Results: Fifty-four (39.1%) and eighty-three (60.1%) patients had abnormal liver enzyme levels on admission and during the course of disease. Hepatocyte type was more common than cholestatic type abnormal. 24(17.4%) patients reached the liver injury standard in the course of disease. Patients with abnormal liver enzyme levels were more likely to be male, had higher levels of inflammation indicators, lower pulse oxygen saturation and lymphocyte count. There is a significantly higher proportion of abnormal liver enzymes levels in the patients which administrated antibiotics during hospitalization, compared with that in the ones without antibiotics therapy (56.6% vs 32.7%). Patients with liver injury was an independent predictor of a poor prognosis (p<0.0001, OR 7.774, 95%CI 2.674-22.599).Conclusions: Liver injury in COVID-19 patients was an independent predictor of a poor prognosis. The COVID-19-related abnormal liver enzymes levels may be considered as the result of secondary liver damage caused mainly by several factors. Hypoxia and disease severity account for the largest proportion.