Background/Aims@#Recent data indicate the presence of
liver enzyme abnormalities in
patients with coronavirus disease 2019 (COVID-19). We aimed to evaluate the clinical features and
treatment outcomes of COVID-19
patients with abnormal
liver enzymes. @*
Methods@#We performed a retrospective,
multicenter study of 874 COVID-19
patients admitted to five
tertiary hospitals from February 20 to April 14, 2020. Data on clinical features,
laboratory parameters, medications, and
treatment outcomes were collected until April 30, 2020, and compared between
patients with normal and abnormal
aminotransferases. @*Results@#Abnormal
aminotransferase levels were observed in 362
patients (41.1%), of which 94 out of 130 (72.3%) and 268 out of 744 (36.0%) belonged to the severe and non-severe COVID-19 categories, respectively. The
odds ratios (95%
confidence interval) for
male patients,
patients with a higher
body mass index,
patients with severe COVID-19 status, and
patients with lower
platelet counts were 1.500 (1.029 to 2.184, p=0.035), 1.097 (1.012 to 1.189, p=0.024), 2.377 (1.458 to 3.875, p=0.001), and 0.995 (0.993 to 0.998, p>0.001), respectively, indicating an independent
association of these variables with elevated
aminotransferase levels.
Lopinavir/
ritonavir and
antibiotic use increased the
odds ratio of abnormal
aminotransferase levels after admission (1.832 and 2.646, respectively, both p<0.05). The median
time to release from
quarantine was longer (22 days vs 26 days, p=0.001) and the mortality rate was higher (13.0% vs 2.9%, p<0.001) in
patients with abnormal
aminotransferase levels. @*Conclusions@#Abnormal
aminotransferase levels are common in COVID-19
patients and are associated with poor clinical outcomes.
Multivariate analysis of
patients with normal
aminotransferase levels on admission showed that the use of
lopinavir/
ritonavir and
antibiotics was associated with abnormal
aminotransferase levels; thus, careful
monitoring is needed.