Evaluation of serum hepatic enzyme activities in different COVID-19 phenotypes.

Liao, Fan-Lu; Peng, Ding-Hui; Chen, Wei; Hu, Han-Ning; Tang, Peng; Liu, Yan-Yuan; Luo, Yi; Yao, Tao

BACKGROUND Coronavirus Disease 2019 (COVID-19) is a newly emerging infectious disease. Our understanding of clinical characteristics of liver damage and the relationship with disease severity in COVID-19 is still limited. AIM To investigate the serum hepatic enzyme activities in different phenotypes of COVID-19 patients, evaluate their relationship with the illness severity, and analyze correlation of glycyrrhizin treatment and abnormal liver enzyme activities. METHODS 147 patients with COVID-19 were employed in a retrospective study that investigated hepatic dysfunction. Liver alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactic dehydrogenase (LDH), gamma-glutamyl transferase (GGT), superoxide dismutase (SOD), and alkaline phosphatase (ALP) were analyzed in these patients. Patients with diammonium glycyrrhizinate (DG) treatment were further investigated. RESULTS Of the 147 patients, 56 (38.1%) had abnormal ALT activity and 80 (54.4%) had abnormal AST activity. The peak of abnormal hepatic enzyme activities occurred at 3 to 6 days after on admission. Serum AST and LDH levels were elevated, while the SOD level was decreased in severe and critical patients, compared with mild cases. DG treatment may alleviate the abnormal liver enzyme activities in non-critical COVID-19 patients. CONCLUSIONS Abnormal liver functions may be observed in patients with COVID-19, which were associated with SARS-CoV-2 induced acute liver damage. Glycyrrhizin treatment may be an effective therapeutic approach for the outcome of abnormal hepatic enzyme activities in severe COVID-19 cases. Serum hepatic enzyme tests may reflect the illness severity and should be monitored. This article is protected by copyright. All rights reserved.