Elevated Liver Enzymes along with Comorbidity Is a High Risk Factor for COVID-19 Mortality: A South Indian Study on 1,512 Patients

• Published in: Journal of clinical and translational hepatology Vol. 10; no. 1; pp. 120 - 127
• Main Authors: Krishnasamy, Narayanasamy, Rajendran, Karthick, Barua, Parimita, Ramachandran, Arunkumar, Panneerselvam, Priyadarshini, Rajaram, Muthukumaran
• Format: Journal Article
• Language: English
• Published: China XIA & HE Publishing Inc 28.02.2022
• Subjects: Original; COVID-19; Liver enzyme; SARS-CoV-2; Alanine aminotransferase; Aspartate aminotransferase; Comorbidity
• ISSN: 2225-0719; 2310-8819
• DOI: 10.14218/JCTH.2020.00100

Liver enzyme abnormalities in coronavirus 2019 (COVID-19) are being addressed in the literature. The predictive risk of elevated liver enzymes has not been established for COVID-19 mortality. In this study, we hypothesized that elevated liver enzymes at admission can predict the outcome of COVID-19 disease with other known indicators, such as comorbidities. This retrospective study included all the consecutive hospitalized patients with confirmed COVID-19 disease from March 4 to May 31 , 2020. The study was conducted in Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India. We assessed demography, clinical variables, COVID-19 severity, laboratory parameters, and outcome. We included 1,512 patients, and median age was 47 years (interquartile range: 34-60) with 36.9% being female. Liver enzyme level (aspartate aminotransferase and/or alanine aminotransferase) was elevated in 450/1,512 (29.76%) patients. Comorbidity was present in 713/1,512 (47.16%) patients. Patients with liver enzymes' elevation and presence of comorbidity were older, more frequently hospitalized in ICU and had more severe symptoms of COVID-19 at the time of admission. Presence of liver enzymes' elevation with comorbidity was a high risk factor for death (OR: 5.314, 95% CI: 2.278-12.393), as compared to patients with presence of comorbidity (OR: 4.096, 95% CI: 1.833-9.157). Comorbidity combined with liver enzymes' elevation at presentation independently increased the risk of death in COVID-19 by at least 5-fold.