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Comment
. 2022 Sep;156(3):484-499.
doi: 10.4103/ijmr.ijmr_1468_21.

Pattern of liver function test variations in COVID-19 infection & its clinical significance: A study from a dedicated COVID-19 tertiary care centre from India

Sanjay J Chandnani  1 , Shubham Jain  1 , Pankaj Nawghare  1 , Partha Debnath  1 , Siddhesh Rane  1 , Rahul Deshmukh  1 , Saurabh Bansal  1 , Sameet Patel  1 , Ravi Thanage  1 , Parmeshwar Junare  1 , Qais Contractor  1 , Pravin M Rathi  1 , Anupam Kumar Singh  2
Affiliations
Comment

Pattern of liver function test variations in COVID-19 infection & its clinical significance: A study from a dedicated COVID-19 tertiary care centre from India

Sanjay J Chandnani et al. Indian J Med Res. 2022 Sep.

Abstract

Background & objectives: Coronavirus disease 2019 (COVID-19) affects respiratory, gastrointestinal, cardiovascular and other systems disease. Studies describing liver involvement and liver function test (LFT) abnormalities are sparse from our population. This study was undertaken to estimate the LFT abnormalities in patients with COVID-19 in a tertiary care set up in India.

Methods: In this retrospective study conducted at a tertiary care centre in Mumbai, India, all consecutive patients with proven COVID-19 by reverse transcriptase-PCR from March 23 to October 31, 2020 were enrolled. Of the 3280 case records profiled, 1474 cases were included in the study. Clinical characteristics, biochemical parameters and outcomes were recorded.

Results: Overall 681 (46%) patient had deranged LFTs. Hepatocellular type of injury was most common (93%). Patients with deranged LFTs had more probability of developing severe disease (P<0.001) and mortality (P<0.001). Advanced age (P<0.001), male gender (P<0.001), diabetes mellitus (P<0.001), lower oxygen saturation levels at admission (P<0.001), higher neutrophil-lymphocyte ratio (P<0.001), history of diabetes mellitus and cirrhosiss were associated with deranged LFTs. Acute liver injury was seen in 65 (4.3%) cases on admission and 57 (3.5%) cases during hospital stay. On multivariate analysis for predicting mortality, age >60 yr serum creatinine >2 mg%, PaO2/FiO2 ratio ≤200 and raised AST >50 IU/l (OR: 2.34, CI: 1.59-3.48, P<0.001) were found to be significant.

Interpretation & conclusions: In COVID-19, LFT abnormalities were common, and derangement increased as severity progressed. The presence of deranged LFT worsens the clinical outcome and predicts in-hospital mortality.

Keywords: COVID-19; hepatitis; liver function tests; mortality; respiratory distress syndrome –SARS-CoV-2.

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Conflict of interest statement

Conflicts of Interest: None.

Figures

Fig. 1
Fig. 1
Flow chart showing Patient selection process. LFT, liver function test
Fig. 2
Fig. 2
Graphs showing area under receiver operating characteristic (AUROC) of different variables in predicting mortality. (A) age, (B) SpO2 on admission, (C) creatinine, (D) total bilirubin on admission, (E) AST on admission, (F) ALT on admission. AST, aspartate transaminase; ALT, alanine transaminase; SpO2, oxygen saturation.
Fig. 3
Fig. 3
Comparison of different variables and their area under receiver operating characteristic (AUROC) curve in predicting mortality.
See this image and copyright information in PMC

Comment on

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