Published online Nov 27, 2022. doi: 10.4254/wjh.v14.i11.1953
Peer-review started: October 1, 2022
First decision: October 17, 2022
Revised: October 25, 2022
Accepted: November 21, 2022
Article in press: November 21, 2022
Published online: November 27, 2022
Asymptomatic infections and mild symptoms are common in patients infected with the Omicron variant, and data on liver test abnormalities are rare.
To evaluated the clinical characteristics of asymptomatic and mild coronavirus disease 2019 (COVID-19) patients with abnormal liver test results.
This retrospective study included 661 laboratory-confirmed asymptomatic and mild COVID-19 patients who were treated in two makeshift hospitals in Ningbo from April 5, 2022 to April 29, 2022. Clinical information and viral shedding time were collected, and univariate and multivariate logistic regression models were performed in statistical analyses.
Of the 661 patients, 83 (12.6%) had liver test abnormalities, and 6 (0.9%) had liver injuries. Abnormal liver tests revealed a reliable correlation with a history of liver disease (P < 0.001) and a potential correlation with male sex and obesity (P < 0.05). Elevated alanine aminotransferase was reliably associated with obesity (P < 0.05) and a history of liver disease (P < 0.001). Elevated aspartate transaminase (AST) was reliably correlated with a history of liver disease (P < 0.001), and potentially correlated with age over 30 years (P < 0.05). There was a reliable correlation between AST ≥ 2× the upper limit of normal and a longer viral shedding time, especially in mild cases.
Obesity and a history of liver disease are risk factors for liver test abnormalities. Being male and an older age are potential risk factors. Attention should be given to liver tests in asymptomatic and mild COVID-19 patients, which has crucial clinical significance for evaluating the viral shedding time.
Core Tip: This is the first clinical study focusing on liver test abnormalities in asymptomatic and mild coronavirus disease 2019 patients. Unlike studies concerning severe cases, we focused on the association between liver test results and viral shedding time in patients infected with the Omicron BA2.2 variant, with a relatively high proportion of asymptomatic carriers and mild cases. The viral shedding time for patients with elevated aspartate transaminase were significantly longer, especially in mild patients. This provides crucial evidence for identifying high-risk patients with a prolonged viral shedding time.