Effect of COVID-19 on Liver Abnormalities: A Systematic review and Meta‐analysis

Emerging evidence suggest association of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection with development of many liver abnormalities. The overarching aim of this study was therefore to assess the available evidence on the clinical effects of SARS-CoV-2 on liver function laboratory tests and coagulation profile in affected individuals. We considered all study designs including epidemiological and observational that reported liver function test abnormalities in patients diagnosed with SARS-CoV-2 infection. Medline, Embase databases and Google Scholar as well as relevant reviews were searched to identify appropriate studies from inception to April 30 th , 2020. We calculated pooled mean with 95% confidence intervals (95%CI) through a random-effect model meta-analysis. A total of 29 studies with 9991 participants were considered for the review from which 20 studies with sufficient quantitative data were included for the meta-analysis. The pooled mean for liver enzymes and coagulation parameters did not significantly change in patients affected by COVID-19 and remained within normal range. Our systematic review and meta-analysis findings of the available evidence suggest that COVID-19 did not have a significant impact on the liver enzymes or coagulation profile of patients with SARS-CoV-2 infection. Future studies need to adequately report all the liver function parameters with event rates.