Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Nov 16:11:636999.
doi: 10.3389/fcimb.2021.636999. eCollection 2021.

Prognostic Potential of Liver Enzymes in Patients With COVID-19 at the Leishenshan Hospital in Wuhan

Zeming Liu  1 , Di Hu  2 , Jinpeng Li  3 , Qing Xia  4 , Yan Gong  5 , Zhengwei Li  6 , Qian Wu  6 , Meilin Yi  7 , Yihui Huang  2 , Meng Wu  8 , Liang Guo  2 , Xiaohui Wu  6
Affiliations

Prognostic Potential of Liver Enzymes in Patients With COVID-19 at the Leishenshan Hospital in Wuhan

Zeming Liu et al. Front Cell Infect Microbiol. .

Abstract

Background: Coronavirus disease 2019 (COVID-19) has evolved into a pandemic. We hypothesized that biochemical indicators of liver function may help determine the prognosis of COVID-19 patients.

Methods: Patient information was collected from the Wuhan-Leishenshan hospital. Logistic and Cox regression analyses, Kaplan-Meier curves, and Curve fitting were used to determine the correlation between elevated levels of aspartate transaminase (AST), alanine transaminase (ALT), and AST/ALT and severity of disease/mortality.

Results: Logistic and Cox regression analyses and Kaplan-Meier survival curves showed that COVID-19 progression correlated with elevated levels of AST and AST/ALT. The odds ratios for elevated levels of AST and AST/ALT in patients were 0.818 (95% confidence interval [CI]: 0.274-2.441, P = 0.035) and 2.055 (95% CI: 1.269-3.327, P = 0.003), respectively; the hazard ratios were 4.195 (95% CI: 1.219-14.422, P = 0.023) and 3.348 (95% CI: 1.57-7.139, P = 0.002), respectively. The Kaplan-Meier survival curves demonstrated that patients with elevated AST and AST/ALT levels had a higher risk of developing severe COVID-19.

Conclusion: Elevated AST and AST/ALT levels correlated with severity of COVID-19 and mortality. Liver function tests may help clinicians in determining the prognosis of patients undergoing treatment for COVID-19.

Keywords: ALT - alanine transaminase; AST - aspartate transaminase; AST/ALT; COVID-19; aspartate aminotransferase/alanine aminotransferase; pneumonia.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Kaplan-Meier survival curves for patients with normal and elevated levels of aspartate transaminase (AST) and alanine aminotransferase (ALT).
Figure 2
Figure 2
Fitting curves for COVID-19 patients with normal/elevated levels of AST based on CT score. Dynamic changes in patients with (A) CT score 1 and normal AST; (B) CT score 2 and normal AST; (C) total CT score and normal AST; (D) CT score 1 and elevated AST; (E) CT score 2 and elevated AST; and (F) total CT score and elevated AST.
Figure 3
Figure 3
Fitting curves for patients with COVID-19 based on normal/elevated ALT levels and CT scores. Dynamic changes in patients with (A) CT score 1 and normal ALT; (B) CT score 2 and normal ALT; (C) total CT score and normal ALT; (D) CT score 1 and elevated ALT; (E) CT score 2 and elevated ALT; and (F) total CT score and elevated ALT.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Cai Q., Huang D., Yu H., Zhu Z., Xia Z., Su Y., et al. . (2020). COVID-19: Abnormal Liver Function Tests. J. Hepatol. 73 (3), 566–574. doi: 10.1016/j.jhep.2020.04.006 - DOI - PMC - PubMed
    1. Chai X., Hu L., Zhang Y., Han W., Lu Z., Ke A., et al. . (2020). Specific ACE2 Expression in Cholangiocytes May Cause Liver Damage After 2019-nCoV Infection. bioRxiv 2020.02.03.931766. doi: 10.1101/2020.02.03.931766 - DOI
    1. Chau T.-N., Lee K.-C., Yao H., Tsang T.-Y., Chow T.-C., Yeung Y.-C., et al. . (2004). SARS-Associated Viral Hepatitis Caused by a Novel Coronavirus: Report of Three Cases. Hepatology 39 (2), 302–310. doi: 10.1002/hep.20111 - DOI - PMC - PubMed
    1. Hoffmann M., Kleine-Weber H., Schroeder S., Krüger N., Herrler T., Erichsen S., et al. . (2020). SARS-CoV-2 Cell Entry Depends on ACE2 and TMPRSS2 and Is Blocked by a Clinically Proven Protease Inhibitor. Cell 181 (2), 271–280. doi: 10.1016/j.cell.2020.02.052 - DOI - PMC - PubMed
    1. Huang C., Wang Y., Li X., Ren L., Zhao J., Hu Y., et al. . (2020). Clinical Features of Patients Infected With 2019 Novel Coronavirus in Wuhan, China. Lancet (London England) 395 (10223), 497–506. doi: 10.1016/S0140-6736(20)30183-5 - DOI - PMC - PubMed