ABSTRACT
Background: Coronavirus is a single-stranded RNA virus, causing an epidemic of pneumonia and acute respiratory distress syndrome (ARDS) worldwide in late 2019. Objectives: In addition to the clinical symptoms, laboratory diagnosis can greatly help diagnose the diseases;therefore, this study aimed to analyze laboratory parameters in patients with COVID-19. Methods: In this cross-sectional study, the laboratory data of 2563 patients with COVID-19 admitted to hospitals affiliated with Mazandaran University of Medical Sciences were extracted from hospital information systems (HIS). The data were recorded on Excel and analyzed through t-test, chi-squared, and Fisher's exact tests in SPSS 19 at the significance level of P < 0.05. Results: Out of 2563 patients with a mean age of 55.1 +/- 16.7 years, 1409 (55%) were male, and 1154 (45%) were female with a mean age of 55.7 +/- 16.8, and 54.3 +/- 16.6 years, respectively. As the most frequent clinical findings, ESR, CRP, and LDH were increased by 83.5%, 71%, and 69.3% of the patients, respectively. Other research findings included lymphopenia, disturbed INR, abnormal SGOT, abnormal alkaline phosphatase (ALP), and increased lactate dehydrogenase (LDH), which were significantly higher in men than in women and was different between age groups. Conclusions: Conducting simple, convenient, and inexpensive laboratory tests can be helpful in the diagnosis of COVID-19.
ABSTRACT
Background: One of the most critical health issues in the world is the COVID-19 pandemic from the Coronaviridae family. There is a lack of knowledge regarding the disease, and liver involvement is controversial. Objectives: We aimed to analyze the laboratory investigations of COVID-19 patients focusing on liver enzymes and association with outcomes. Methods: We enrolled 93 patients with COVID-19 referring to the Mazandaran University of Medical Sciences’ hospitals and 186 people from the normal population of Tabari Cohort. The laboratory tests included CBC, Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT), Alkaline Phosphatase (ALP), direct bilirubin, and total bilirubin. The lengths of hospital stay, critical care transfers, and deaths were the outcome measures investigated with lab results. Results: The counts of lymphocytes (833.3 ± 564.4 vs. 2465.1 ± 796.6 per mm3, P < 0.001) and platelets (209.4 ± 62.7 vs. 255.2 ± 63.8 per mm3, P < 0.001) were significantly lower in patients than in controls. Also, AST (39.5 ± 34.9 vs. 19.9 ± 7.5 U/L, P < 0.001), ALT (40.4 ± 46.5 vs. 21.6 ± 12.7 U/L, P < 0.001), and ALP (192.6 ± 91.2 vs. 222.2 ± 70.6 U/L, P = 0.004) were higher in patients than in controls. The most common hepatic impairment events were increased direct bilirubin (45.8%), ALT (30.3%), AST (29.2%), ALP (17%), and total bilirubin (10.2%), in sequence. The risk of transfer to intensive and critical care units was strongly associated with elevated levels of AST and direct bilirubin, and AST = 30.5 (U/L) had a sensitivity of 71.4% and specificity of 68.5% for critical and intensive care transfer. The mortality rate significantly increased with increased AST levels (P = 0.023). Conclusions: Abnormal liver enzymes are frequent in COVID-19 patients. As AST is not specific for liver damage, the systemic inflammation induced by the virus might be responsible for these findings.