Acute liver injury and its association with death risk of patients with COVID-19: a hospital-based prospective case-cohort study

Lin Fu; Jun Fei; Shen Xu; Hui-Xian Xiang; Ying Xiang; Zhu-Xia Tan; Meng-Die Li; Fang-Fang Liu; Ying Li; Ming-Feng Han; Xiu-Yong Li; Hui Zhao; De-Xiang Xu

The association between the severity and ALI was analyzed among COVID-19 patients. As shown in Table 1 , all hepatocellular injury markers, including total bilirubin, direct bilirubin, indirect bilirubin, ALT and AST, were higher in critically ill patients than those of common cases. By contrast, total protein, albumin and albumin/globulin ratio, three markers of hypoproteinemia were lower in critically ill patients than those of common cases. Despite of no difference on serum TBA, alkaline phosphatase and glutamyl transferase, two markers of cholestasis, were higher in critically ill patients than those of common cases. The association between oxygenation index and hepatic functional indexes was analyzed. As shown in Figure 1 , there was a weak negative correlation between oxygenation index and ALT, AST, AST/ALT, and glutamyl transferase. By contrast, there was a weak positive correlation between oxygenation index and albumin among COVID-19 patients ( Figure 1 ).