Liver enzyme abnormalities and its effects on mortality in coronavirus disease-2019

Liver Enzyme Abnormalities and its Effects on Mortality in Coronavirus Disease-2019 Objective: To investigate the course of liver enzyme abnormalities and the effect of enzyme level changes on mortality among hospitalized patients due to Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection. Method: 1455 patients hospitalized in pandemic wards and pandemic intensive care units of Uşak Training and Research Hospital between March 20th, 2020, and March 20th, 2021, were included. These patients' serum creatinine, LDH (lactate dehydrogenase), AST (aspartate aminotransferase), ALT (alanine aminotransferase), total bilirubin, complete blood count, CRP values, and patient age, gender, presence of symptoms, admission oxygen saturation values were obtained from the patient files. Laboratory data and patients' characteristics were evaluated to investigate the effect on mortality retrospectively. Result: 1455 patients were included. The median age of the patients was 58 (18-94) years. 52.4% (n=763) of the patients were female. 7.49% of patients (n=109) died. Patients with AST and/or ALT levels twofold higher than the upper normal limit were defined as a study group. The study group comprised 76 patients. In the study group, LDH and bilirubin values were significantly higher than the control group (p values were <0.001 and <0.001, respectively). Lymphocyte counts were lower in the study group compared to the control group (p=0.026). The hemoglobin levels significantly differed between the study and control groups (p=0.045). Also, CRP levels were statistically higher in the study group (p=0,023). The two groups did not differ when comparing clinical, laboratory, and imaging variables. Multivariate Cox regression analysis revealed that age, CRP level, presence of symptoms, and oxygen saturation on admission were significant factors for COVID-19 mortality. Conclusion: It was shown that among patients hospitalized for Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection follow-up and treatment, liver enzyme elevations on admission did not affect COVID-19 infection-related mortality. Independent risk factors that determined mortality were age, CRP level, presence of symptoms, and oxygen saturation on admission.