Effect of COVID-19 infection on liver enzymes: A prospective study in Western Part of Nepal

ABSTRACT

Objectives: Background: Coronavirus disease 2019 (COVID-19), a global pandemic, has hit the whole world since December, 2019. COVID-19 has got multi-organ impact and liver is no exception. Studies have shown raised liver enzymes primarily alanine aminotransferase (ALT), aspartate aminotransferase (AST), and alkaline phoshatase (ALP);the mechanism being multifactorial. Aims: To evaluate the effect of COVID-19 infection on liver enzymes. Materials and Methods: It is a prospective study conducted at Mediplus Hospital and Trauma Center from 1st January, 2021 to 30th June, 2021. Ethical approval was obtained and a total of 210 PCR positive COVID-19 inpatients were included. Liver enzymes (ALT, AST and ALP) were measured. Data was entered in Microsoft excel and result studied. Results: Out of 210 PCR positive COVID-19 patients, 57 (27.1%) had raised liver enzymes, while 153 (72.9%) had normal. Among the raised ones, 13 (22.9%) had ALT raised more than one time of upper normal limit (UNL, 45 IU/L), 29 (50.8%) had ALT raised more than two times of UNL and 15 (26.3%) had ALT raised more than three times of UNL, while 42 (73.7%) had AST raised more than one time of UNL (35 IU/L) and 15 (26.3%) had AST raised more than two times of UNL, and ALP was found to be raised in only 5 (8.7%) patients (Table 1). Conclusion: Raised liver enzymes have been commonly noticed in patients with PCR positive COVID-19 due to its direct or indirect impact on liver. (Figure Presented).