The prevalence, predictors and outcomes of acute liver injury among patients with COVID-19: A systematic review and meta-analysis.

Harapan, Harapan; Fajar, Jonny Karunia; Supriono, Supriono; Soegiarto, Gatot; Wulandari, Laksmi; Seratin, Fiha; Prayudi, Nyoman Gede; Dewi, Dara Puspita; Monica Elsina, Maria Theresia; Atamou, Lasarus; Wiranata, Sinta; Aprianto, Dhito Pemi; Friska, Erlin; Sari Firdaus, D Fitria; Alaidin, Makdum; Wardhani, Firdha Aprillia; Husnah, Milda; Hidayati, Nurdina Wahyu; Hendriyanti, Yeni; Wardani, Kristia; Evatta, Arde; Manugan, Reizal Audi; Pradipto, Wiryawan; Rahmawati, Ade; Tamara, Fredo; Mahendra, Aditya Indra; Nainu, Firzan; Santoso, Budi; Irawan Primasatya, Chandra Adi; Tjionganata, Nindy; Budiman, Hendarto Arif

The data on the predictors and prognosis of acute liver injury (ALI) among patients in coronavirus disease 2019 (COVID-19) patients are limited. The aim of this study was to determine the prevalence, predictors and outcomes of ALI among patients with COVID-19. A systematic review was conducted up to 10 June 2021. The relevant papers were searched from PubMed, Embase, Cochrane and Web of Science, and the data were analysed using a Z test. A total of 1331 papers were identified and 16 papers consisting of 1254 COVID-19 with ALI and 4999 COVID-19 without ALI were analysed. The cumulative prevalence of ALI among patients with COVID-19 was 22.8%. Male and having low lymphocyte levels were more likely to be associated with ALI compared with female and having higher lymphocyte level, odds ratio (OR): 2.70; 95% confidence interval (CI): 2.03, 3.60 and mean difference (MD) -125; 95% CI: -207, -43, respectively. COVID-19 patients with ALI had higher risk of developing severe COVID-19 compared with those without ALI (OR: 3.61; 95% CI: 2.60, 5.02). Our findings may serve as the additional evaluation for the management of ALI in COVID-19 patients.