Analysis of liver injury factors in 332 patients with COVID-19 in Shanghai, China

Guo, Hongying; Zhang, Zhengguo; Zhang, Yuyi; Liu, Yu; Wang, Jiefei; Qian, Zhiping; Zou, Ying; Lu, Hongzhou

Objective: We analyzed clinical parameters and risk factors for coronavirus disease 2019 (COVID-19)-related liver damage. Results: Of the 332 COVID-19 patients, 306 and 26 were included in the non-critical and critical groups, respectively. The median time from onset to admission was 4.0 (2.0–8.0) days. Of the 332 COVID-19 patients, 98 (29.5%) were admitted with liver injury. The rates of aspartate transaminase, γ-glutamyl transpeptidase, and total bilirubin abnormalities were higher in the critical group than in the non-critical group. The patient’s sex, COVID-19 severity, and a low liver CT density strongly correlated with liver injury (ORs: 2.936, 6.543, and 3.387, respectively). Statistical analysis on drug administration after admission showed that the usage rates of lopinavir/ritonavir, glucocorticoids, and thymopeptides were significantly higher in the abnormal group than the normal groups (p<0.05). Conclusions: Though not severe, the liver injury among COVID-19 patients was pervasive. Being male, COVID-19 severity, low CT density, and medications may be risk factors for liver damage. Following recovery, liver function gradually returns to normal. Methods: This retrospective study screened 332 confirmed COVID-19 patients from January 20 to March 13, 2020. Liver indicators were evaluated on admission. The risk factors, medications, and the dynamic change of liver functions were analyzed.