Clinical Significance of Liver Function Abnormality in Patients with COVID-19: A Single-center Experience from Western India

Kalal, C. R.; Joshi, H.; Kumar, V.; Gopal, D.; Rathod, D.; Shukla, A.; Gianchandani, T.; Bhatt, C.

Background and Aims: The impact of coronavirus dis-ease-2019 (COVID-19) on liver function remains to be fully elucidated. This study was designed to investigate such and determine the clinical significance in determining mortality risk. Methods: A retrospective study was conducted in pa-tients with COVID-19 from March 2020 to July 2020. Clini-cal details were retrieved from electronic medical records to obtain clinical characteristics, medical history, laboratory tests, therapeutic intervention, and outcome data. Results: A total of 184 patients with COVID-19 were included (medi-an age: 45.5 years), comprised of 62.5% men. In total, 22 (12.0%) patients had severe infection and 162 (88.0%) had mild to moderate infection. Overall, 95 (51.6%) showed ab-normal liver function test (LFT) and 17 (9.2%) showed nor-mal LFT at admission. The median age, hospital stay, and LFT were significantly higher in severe vs. non-severe infec-tion (p<0.001). Out of 12 deaths, the majority were due to severe infection (n=11). Deaths were also due to acute res-piratory distress syndrome (n=5), cardiac reasons (n=3), and sepsis with multiorgan failure (n=3). The median age, hospital stay and number of intensive care unit admissions were higher in patients having abnormal LFT compared to normal LFT. Incidence of elevated aspartate aminotrans-ferase (42.8% and 40.4%), alanine transaminase (43.7% and 41.6%), and hypoalbuminemia (71.4% and72.7%) at admission and discharge were more common in severe infection. The mean survival was significantly lower in se-vere infection compared to those with non-severe disease (17.2 vs. 52.3 days;p<0.001). Conclusions: Incidence of abnormal liver function was higher in patients with severe COVID-19 and was associated with prolonged hospital stay;mortality was associated with severity of COVID-19. For rul-