Liver dysfunction during COVID-19 pandemic: Contributing role of associated factors in disease progression and severity

Table 1 Studies of abnormal liver biochemistries in patients with coronavirus disease 19

Ref.	Patients (n)	Findings	Conclusion
Wang et al[11], 2020	105	56.2% of the patients had abnormal ALT, AST, and total bilirubin throughout the course of the disease	Patients with COVID-19 often have abnormal liver function indices
Fan et al[12], 2020	148	37.2% had abnormal liver function at hospital admission; 14.5% out of these patients had high fever; patients with abnormal liver function had longer mean hospital stays (15.09 ± 4.79 d) than patients with normal liver function (12.76 ± 4.14 d)	More than one third of SARS-CoV-2 infected patients admitted to hospitals had elevated liver function parameters, which are linked to a prolonged hospital stay
Ding et al[37], 2021	2,073	Out of 2073 patients, 61.8% showed abnormal liver chemistries during hospitalization, and 14.3% had liver injury	COVID-19-related mortality is predicted by abnormal levels of AST and D-Bil during admission. Infection with HBV does not raise the risk of poor COVID-19-related outcomes in patients
Cai et al[38], 2020	417	76.3% had abnormal liver test results and 21.5% had liver injury during hospitalization.ALT, AST, total bilirubin, and gamma-glutamyl transferase levels rose to more than 3 × the upper limit of normal, respectively	The negative effects on liver damage are mostly due to certain drugs taken during hospitalization
Fan et al[41], 2021	288	Except for AST, the levels of total bilirubin and ALP in normal and severe patients varied within the normal range, with an increasing trend in critical patients	In critical patients, COVID-19 can induce significant hepatic dysfunction, necessitating early monitoring and management. Because of their connection with disease severity in COVID-19, LDH, ALP, GGT, total bilirubin, prealbumin, and albumin may be useful for assessing and predicting disease prognosis

COVID-19: Coronavirus disease 19; SARS-CoV-2: Severe acute respiratory syndrome coronavirus-2; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; ALP: Alkaline phosphatase; GGT: Gamma-glutamyltransferase; D-BiL: Direct bilirubin.