Author/Authors :
Anushiravani , Amir Digestive Disease Research Center - Digestive Disease Research Institute - Tehran University of Medical Sciences, Tehran, Iran , Khosravi , Bardia Digestive Disease Research Center - Digestive Disease Research Institute - Tehran University of Medical Sciences, Tehran, Iran , Saberzadeh-Ardestani, Bahar Digestive Disease Research Center - Digestive Disease Research Institute - Tehran University of Medical Sciences, Tehran, Iran , Ghasemi , Ali Zanjan MRI Center - Radiology Department - ValieAsr Hospital, Zanjan, Iran , Kalantari, Saeed Antimicrobial Resistance Research Center - Iran University of Medical Sciences, Tehran, Iran , Sorouri , Majid Digestive Disease Research Center - Digestive Disease Research Institute - Tehran University of Medical Sciences, Tehran, Iran , Mojtabavi , Helia Digestive Disease Research Center - Digestive Disease Research Institute - Tehran University of Medical Sciences, Tehran, Iran , Ghaemi, Omid Department of Radiology - Shariati Hospital - Tehran University of Medical Sciences, Tehran, Iran , Radmard , Amir Reza Department of Radiology - Shariati Hospital - Tehran University of Medical Sciences, Tehran, Iran , Kasaeian, Amir Oncology and Stem Cell Transplantation Research Center - Tehran University of Medical Sciences, Tehran, Iran , Motamedi , Omid Department of Radiology - Rasool Akram Hospital - Iran University of Medical Sciences, Tehran, Iran , Poustchi , Hossein Digestive Disease Research Center - Digestive Disease Research Institute - Tehran University of Medical Sciences, Tehran, Iran , Sima, Ali Reza Digestive Disease Research Center - Digestive Disease Research Institute - Tehran University of Medical Sciences, Tehran, Iran
Abstract :
BACKGROUND
In December 2019, COVID-19 emerged from China and spread to become a pandemic,
killing over 1,350,000 up to November 18, 2020. Some patients with COVID-19 have
abnormal liver function tests. We aimed to determine the clinical significance of liver
chemistries in patients with COVID-19.
METHODS
We performed a cross-sectional study of 1044 consecutive patients with confirmed
COVID-19 in two referral hospitals in Tehran, Iran, from February to April 2020. All cases
were diagnosed by clinical criteria and confirmed by characteristic changes in the spiral chest
computed tomography (CT) and nucleic acid testing of the nasopharyngeal samples. We
evaluated the association between abnormal liver enzymes or function tests and survival,
intensive care unit (ICU) admission and fatty liver changes in CT scans.
RESULTS
The mean age was 61.01 ± 16.77 years, and 57.68% were male. Of 495 patients with
elevated alanine transaminase (ALT) levels, 194 had chest CT scans, in which fatty liver
disease was seen in 38.1%. 41 patients (21.13%) had moderate to severe, and 33 (17.01%)
had borderline fatty liver disease. Bilirubin, albumin, and partial thromboplastin time
(PTT), along with other markers such as HCO3
, C-reactive protein (CRP), triglyceride,
and length of admission, were significantly associated with ICU admission and mortality.
Prothrombin time (PT), platelet count, and low-density lipoprotein (LDL) levels were
also correlated with mortality. Fasting blood sugar (FBS) and pH were important indices
in ICU admitted patients.
CONCLUSION
Liver function tests accurately predict a worse prognosis in patients with COVID-19.
However, liver enzymes were only slightly increased in those who died or needed ICU
admission and were not related to the fatty liver changes.
