The features of the liver function tests in patients with COVID-19

ABSTRACT

It is known that SARS-CoV-2 can cause liver damage due to the tropism of the virus to cholangiocytes and hepatocytes, the development of a cytokine storm, organ ischemia, aggravated in existing chronic liver disease and increasing during hospitalization, which probably can be related to the current drug intake or comorbidity. Evaluation of the frequency of abnormal liver function tests prior to the drugs administration in the hospital would allow to exclude a possible toxic effect. Aim of the study is to establish the prevalence and features of liver function tests (LFT) abnormalities and factors associated with in hospitalized patients with COVID-19. Methods. 248 adult patients with confirmed COVID-19 were admitted to the infectious diseases hospital were selected for an observational cross-sectional study. Patients clinical and laboratory characteristics, the frequency of liver damage are presented, and the relationship with such risk factors as age, gender, comorbidity, prehospital drug intake, COVID-19 severity, oxygen saturation (SaO2), need for admission in intensive care unit is assessed. Results. 41.2% of patients with COVID-19 had LFT abnormalities at the time of admission. Liver damage, represented mainly by cholestatic (76.9%) and hepatocellular (27.4%) patterns, was mild in the most cases. Patients over 50 years were more than twice as likely to show liver damage compared to younger patients (OR 2.24, 95% CI 1.03-4.9). There were no differences in the frequency of liver damage in patients depending on gender (OR 1.3, 95% CI 0.74-2.27), comorbidity (OR 0.91, 95% CI 0.5-1.6), pregnancy (OR 0.85, 95% CI 0.45-1.7), taking drugs before hospitalization (OR 1.3, 95% CI 0.6-2.7), including based on the drugs hepatotoxicity. The prevalence of LFT abnormalities is almost twice as high in patients with severe COVID-19 (OR 1.9, 95% CI 1.1-3.4), not associated with the level of hypoxia (OR 0.7, 95% CI 0.1-7.8), and the need for intensive care (OR 2.8, 95% CI 0.3-32.4). Conclusion. As a result of the study, it was found that at the time of admission to the hospital, most patients with COVID-19 have mild LFT abnormalities, which increase with age and severity of COVID-19. A cohort study should be conducted to overcome the limitations of the current cross-sectional study and draw more definitive conclusions.Copyright © Eco-Vector, 2022.