Risk factors of liver injury in patients with coronavirus disease 2019 in Jiangsu, China: a retrospective, multi-center study.

Wang, Jian; Zhu, Li; Xue, Leyang; Liu, Longgen; Yan, Xuebing; Yan, Xiaomin; Huang, Songping; Zhang, Biao; Xu, Tianmin; Li, Chunyang; Ji, Fang; Ming, Fang; Zhao, Yun; Cheng, Juan; Shao, Huaping; Chen, Kang; Zhao, Xiang-An; Sang, Dawen; Zhao, Haiyan; Guan, Xinying; Chen, Xiaobing; Chen, Yuxin; Liu, Jiacheng; Huang, Rui; Zhu, Chuanwu; Wu, Chao

We aimed to describe liver injury and identify the risk factors of liver injury in COVID-19 patients without chronic liver diseases (CLD). The clinical data of 228 confirmed COVID-19 patients without CLD were retrospectively collected from ten hospitals in Jiangsu, China. Sixty-seven (29.4%) of 228 patients without CLD showed abnormal liver function on admission, including increased alanine aminotransferase (ALT, 25 [11.0%]) U/L, aspartate aminotransferase (AST, 30 [13.2%]) U/L, gamma-glutamyl transferase (GGT, 28 [12.4%]) U/L, total bilirubin (Tbil, 16 [7.0%]) μmol/L, and alkaline phosphatase (ALP, 10 [4.5%]) U/L. During hospitalization, 129 (56.3%) of 228 patients showed abnormal liver function, including elevated ALT (84 [36.8%]), AST (58 [25.4%]), GGT (67 [29.5%]) and Tbil (59 [25.9%]). Age over 50 years (odds ratio [OR] 2.086, 95% confidence interval [CI] 1.030-4.225, P=0.041), male sex (OR 2.737, 95%CI 1.418-5.284, P=0.003), and lopinavir-ritonavir (OR 2.504, 95%CI 1.187-5.283, P=0.016) were associated with higher risk of liver function abnormality, while the atomized inhalation of interferon α-2b (OR 0.256, 95%CI 0.126-0.520, P<0.001) was associated with reduced risk of liver function abnormality during hospitalization. Mild to moderate liver injury was common in COVID-19 patients in Jiangsu, China. Age over 50 years, male sex, and lopinavir-ritonavir were the independent risk factors of liver impairment in COVID-19 patients during hospitalization. This article is protected by copyright. All rights reserved.