Evaluation of liver function tests in patients applied to the hospital with COVID-19 pneumonia

Introduction The COVID-19 outbreak, a SARS-CoV-2 hybrid virus infection that emerged in the autumn of 2019, causes severe acute lower respiratory tract infection and is fatal. In this study, we aimed to examine the abnormalities that this newly emerged hybrid virus may cause in liver tests at the time of diagnosis. Patients and Methods: In our retrospective designed study, we included 100 consecutive patients who applied to Bezmialem Vakıf University Medical Faculty Hospital between February 2020 and April 2020 in the first wave of COVID-19 infection and were diagnosed with COVID-19 pneumonia by thoracic computed tomography with the suspicion of COVID-19 infection, with no known liver disease, hepatotoxic drug use or any comorbid disease that could lead to mortality except for COVID-19 infection. After determining the frequency of liver enzyme abnormalities in these patients, we divided those who survived and those who died in the hospital into 2 groups and investigated the differences between the groups. Results 59 (59%) of the patients were male. The median age was 59 years (range 16-88). While 83 (83%) patients continued to live after admission to the hospital, 17 (17%) died in the hospital. 47 (56.6%) of the survivors were male, and 10 (58.8%) of those who died in the hospital. The median age was 57 years (range 16-85) for those who survived and 70 years (range 48-88) for those who died in hospital. AST was elevated in 33%, ALT in 2%, ALP in 3.7%, and GGT in 46.2% of the patients. In the univariate analysis, age (p=0.003), AST (p<0.001), ALT (p=0.016), GGT (p=0.006), albumin (p=0.001), INR (p=0.024), Crp (p<0.001) and ferritin (p<0.001) were found to be significantly different between those who survived and those who died in hospital. In the multivariate analysis, only ferritin was significant (Relative Risk 1.003 at 95% Confidence Interval (1.000-1.005, p=0.037)). In correlation tests; in those surviving AST; was well correlated with ALT (r=0.593, p<0.001), ferritin (r=0.585, p<0.001) and crp (r=0.528, p<0.001) and moderately associated with CK (r=0.410, p<0.001). In hospital deaths; AST correlated very well with ALT (r=0.905, p<0.001), good with leukocyte count (r=0.673, p=0.003), weakly with creatin kinase (r=0.341) and platelet number (r=0.345), while inversely correlated moderately with albumin (r=-0.448). Conclusions: We determined that AST and GGT were elevated on admission to hospital in COVID-19 infection, but they were not associated with mortality. We think that the elevation of these two enzymes may be associated with fatty liver. Therefore, we think that the development of hepatosteatosis should be clarified with pathology-based studies.