Evaluation of serum hepatic enzyme activities in different COVID‐19 phenotypes

• Published in: Journal of Medical Virology Vol. 93; no. 4; pp. 2365 - 2373
• Main Authors: Liao, Fan‐Lu, Peng, Ding‐Hui, Chen, Wei, Hu, Han‐Ning, Tang, Peng, Liu, Yan‐Yuan, Luo, Yi, Yao, Tao
• Format: Journal Article Web Resource
• Language: English
• Published: United States John Wiley & Sons, Inc 01.04.2021; Wiley Subscription Services, Inc
• Subjects: Adult; Aged; Aged, 80 and over; Alanine; Alanine transaminase; Alanine Transaminase - blood; Alkaline phosphatase; Alkaline Phosphatase - blood; Aspartate aminotransferase; Aspartate Aminotransferases - blood; Coronaviruses; Correlation analysis; COVID-19; COVID-19 - blood; COVID-19 - enzymology; COVID-19 - metabolism; Damage; diammonium glycyrrhizinate; Enzymatic activity; Enzymes; Female; Glycyrrhizin; Health services; hepatic enzyme activities; Humans; Illnesses; Infectious diseases; Liver; Liver - enzymology; Liver - metabolism; liver damage; Liver diseases; Liver Function Tests; Male; Middle Aged; Patients; Phenotype; Phenotypes; Retrospective Studies; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Severity of Illness Index; Superoxide dismutase; Superoxide Dismutase - blood; Viral diseases; Virology; Young Adult; COVID-19; hepatic enzyme activities; SARS-CoV-2; diammonium glycyrrhizinate; liver damage
• ISSN: 0146-6615; 1096-9071
• DOI: 10.1002/jmv.26729

Coronavirus disease 2019 (COVID‐19) is a newly emerging infectious disease. Our understanding of the clinical characteristics of liver damage and the relationship with disease severity in COVID‐19 is still limited. To investigate the serum hepatic enzyme activities in different phenotypes of COVID‐19 patients, evaluate their relationship with the illness severity and analyze the correlation of glycyrrhizin treatment and abnormal liver enzyme activities, one hundred and forty‐seven patients with COVID‐19 were enrolled in a retrospective study that investigated hepatic dysfunction. Liver alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactic dehydrogenase (LDH), Y‐glutamyl transferase (GGT), superoxide dismutase (SOD), and alkaline phosphatase (ALP) were analyzed in these patients. Patients with diammonium glycyrrhizinate (DG) treatment were further investigated. Of the 147 patients, 56 (38.1%) had abnormal ALT activity and 80 (54.4%) had abnormal AST activity. The peak of abnormal hepatic enzyme activities occurred at 3 to 6 days after on admission. Serum AST and LDH levels were elevated, while the SOD level was decreased in severe and critical patients, compared with mild cases. DG treatment may alleviate the abnormal liver enzyme activities in non‐critical COVID‐19 patients. Abnormal liver functions may be observed in patients with COVID‐19, and were associated with SARS‐CoV‐2‐induced acute liver damage. Glycyrrhizin treatment may be an effective therapeutic approach for the outcome of abnormal hepatic enzyme activities in severe COVID‐19 cases. Serum hepatic enzyme tests may reflect the illness severity and should be monitored.