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Meta-Analysis
. 2021 May 19;11(1):10599.
doi: 10.1038/s41598-021-89513-9.

Effect of COVID-19 on liver abnormalities: a systematic review and meta-analysis

Khalid Bzeizi  1 , Maheeba Abdulla  2 , Nafeesa Mohammed  2 , Jehad Alqamish  3 , Negar Jamshidi  4 , Dieter Broering  5
Affiliations
Meta-Analysis

Effect of COVID-19 on liver abnormalities: a systematic review and meta-analysis

Khalid Bzeizi et al. Sci Rep. .

Abstract

Emerging evidence suggest association of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection with the development of many liver abnormalities. The overarching aim of this study was therefore to assess the available evidence on the clinical effects of SARS-CoV-2 on the profiles of liver chemistries and coagulation in COVID-19 diagnosed patients. We considered all study designs including epidemiological and observational that reported liver function test abnormalities in patients confirmed with SARS-CoV-2 infection. Medline, Embase databases and Google Scholar as well as relevant reviews were searched to identify appropriate studies from inception to 31st of August 2020. We calculated the pooled mean with 95% confidence intervals (95% CI) through a random-effect model meta-analysis. A total of 35 studies with 10,692 participants were considered for the review from which 23 studies with sufficient quantitative data were included in the meta-analysis. The pooled mean for liver enzymes and coagulation parameters did not significantly change in patients diagnosed with COVID-19 and remained within normal range. Notwithstanding potential bias from confounding factors in interpretation of data in this review, findings from the observational studies and case reports suggest that COVID-19 does not appear to have a significant impact on the transaminases or total bilirubin levels of patients with confirmed SARS-CoV-2 infection. Further controlled studies and larger sample size observational studies are needed with adequate reporting of other liver function parameters are warranted.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Study protocol according to PRISMA flow chart.
Figure 2
Figure 2
Meta-analyses of the pooled mean of Liver enzymes. (A) Albumin; (B) Globulin; (C) Alanine aminotransferase; (D) Alkaline phosphatase; (E) Aspartate aminotransferase; (F) Gamma-glutamyl transferase.
Figure 2
Figure 2
Meta-analyses of the pooled mean of Liver enzymes. (A) Albumin; (B) Globulin; (C) Alanine aminotransferase; (D) Alkaline phosphatase; (E) Aspartate aminotransferase; (F) Gamma-glutamyl transferase.
Figure 2
Figure 2
Meta-analyses of the pooled mean of Liver enzymes. (A) Albumin; (B) Globulin; (C) Alanine aminotransferase; (D) Alkaline phosphatase; (E) Aspartate aminotransferase; (F) Gamma-glutamyl transferase.
Figure 3
Figure 3
Meta-analyses of the pooled mean of coagulation parameters. (A) prothrombin time; (B) Activated Partial Thromboplastin time.
See this image and copyright information in PMC

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