Clinical characteristics of non-ICU hospitalized patients with coronavirus disease 2019 and liver injury: A retrospective study

Liver Int. 2020 Jun;40(6):1321-1326. doi: 10.1111/liv.14449. Epub 2020 Apr 12.

Abstract

Background & aims: Coronavirus disease 2019 (COVID-19) has raised world concern for global epidemic since December, 2019. Limited data are available for liver function in COVID-19 patients. We aimed to investigate the risk factors related to liver injury in the COVID-19 patients.

Methods: A retrospective study was performed in non-ICU Ward at Jinyintan Hospital from February 2, 2020 to February 23, 2020. Consecutively confirmed COVID-19 discharged cases were enrolled. The clinical characteristics of patients with liver injury and without liver injury were compared.

Results: A total of 79 COVID-19 patients were included. 31.6%, 35.4% and 5.1% COVID-19 patients had elevated levels of alanine transaminase (ALT), aspartate aminotransferase (AST) and bilirubin respectively. Median value of ALT, AST and bilirubin for entire cohort was 36.5 (17.5 ~ 71.5) U/L, 34.5 (25.3 ~ 55.3) U/L and 12.7 (8.1 ~ 15.4) mmol/L respectively. There were no significant differences in age, previous medical history and symptoms between the two groups. Males were more likely to have liver injury when infected with COVID-19 (P < .05); compared with patients without liver injury, patients with liver injury had increased levels of white blood cell counts, neutrophils, CRP and CT score (P < .05) and had a longer length of stay (P < .05). Logistic regression analyses suggested that the extent of pulmonary lesions on CT was a predictor of liver function damage (P < .05).

Conclusions: Liver injury is common in non-ICU hospitalized COVID-19 patients. It may be related to systemic inflammation. Intense monitoring and evaluation of liver function in patients with severe pulmonary imaging lesions should be considered.

Keywords: COVID-19; liver injury; pulmonary lesions; systemic inflammation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Alanine Transaminase / blood
  • Aspartate Aminotransferases / blood
  • Betacoronavirus / isolation & purification*
  • Bilirubin / blood
  • COVID-19
  • China / epidemiology
  • Coronavirus Infections* / blood
  • Coronavirus Infections* / complications
  • Coronavirus Infections* / diagnosis
  • Coronavirus Infections* / epidemiology
  • Female
  • Hospitalization / statistics & numerical data
  • Humans
  • Liver Diseases* / blood
  • Liver Diseases* / diagnosis
  • Liver Diseases* / epidemiology
  • Liver Diseases* / etiology
  • Liver Function Tests / methods*
  • Lung / diagnostic imaging
  • Male
  • Middle Aged
  • Pandemics*
  • Pneumonia, Viral* / blood
  • Pneumonia, Viral* / complications
  • Pneumonia, Viral* / diagnosis
  • Pneumonia, Viral* / epidemiology
  • Pneumonia, Viral* / etiology
  • Prevalence
  • Risk Factors
  • SARS-CoV-2
  • Tomography, X-Ray Computed / methods

Substances

  • Aspartate Aminotransferases
  • Alanine Transaminase
  • Bilirubin