COVID‐19 and Liver Dysfunction: a systematic review and meta‐analysis of retrospective studies

Youssef, Mohanad; Hussein, Mohammad; Attia, Abdallah S; Elshazli, Rami; Omar, Mahmoud; Zora, Ghassan; Farhoud, Ashraf; Elnahla, Ahmad; Shihabi, Areej; Toraih, Eman; Fawzy, Manal; Kandil, Emad

BACKGROUND: Recently, Coronavirus Disease 2019 (COVID‐19) pandemic is the most significant global health crisis. In this study, we conducted a meta‐analysis to find the association between liver injuries and the severity of COVID‐19 disease. METHODS: Online databases, including PubMed, Web of Science, Scopus, and Science direct, were searched to detect relevant publications up to April 16, 2020. Depending on the heterogeneity between studies, a fixed‐ or random‐effects model was applied to pool data. Publication bias Egger's test was also performed. RESULTS: Meta‐analysis of 20 retrospective studies (3428 patients), identified that patients with a severe manifestation of COVID‐19 exhibited significantly higher levels of alanine aminotransferase, aspartate aminotransferase, and bilirubin values with prolonged prothrombin time. Furthermore, lower albumin level was associated with a severe presentation of COVID‐19. CONCLUSION: Liver dysfunction was associated with a severe outcome of COVID‐19 disease. Close monitoring of the occurrence of liver dysfunction is beneficial in early warning of unfavorable outcomes. This article is protected by copyright. All rights reserved.