Published online Feb 7, 2022. doi: 10.3748/wjg.v28.i5.570
Peer-review started: May 17, 2021
First decision: July 14, 2021
Revised: July 21, 2021
Accepted: January 20, 2022
Article in press: January 20, 2022
Published online: February 7, 2022
Core Tip: Severe acute respiratory syndrome coronavirus-2 primarily infects the respiratory system. However, increasing evidence exists for the direct multiorgan effect. Liver injury in hospitalized patients is associated with a poor prognosis. We investigated whether abnormal liver chemistries in Coronavirus Disease 2019 (COVID-19) hospitalized patients can be of prognostic value. We show that abnormal liver chemistries were commonly observed on hospital admission and are associated with worse outcomes in COVID-19 patients, namely mortality, the need for vasopressor drugs, and mechanical ventilation. In hospitalized COVID-19 patients, elevated liver chemistries, specifically alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, and total bilirubin levels, can be used to stratify risk and predict the need for advanced therapies. These results strongly suggest that abnormal liver chemistries at the time of hospital admission are associated with worse outcomes in COVID-19 patients and should be closely followed in admitted patients.