Systematic Reviews
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Meta-Anal. Apr 28, 2021; 9(2): 193-207
Published online Apr 28, 2021. doi: 10.13105/wjma.v9.i2.193
Laboratory hematologic features of COVID-19 associated liver injury: A systematic review
John L Frater, Tianjiao Wang, Yi-Shan Lee
John L Frater, Tianjiao Wang, Yi-Shan Lee, Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO 63110, United States
Author contributions: Frater JL designed the research study, performed the research, analyzed the data, and wrote the manuscript; Wang T and Lee YS analyzed the data; All authors have read and approved the final manuscript.
Conflict-of-interest statement: All authors declare no conflicts-of-interest related to this article.
PRISMA 2009 Checklist statement: The manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: John L Frater, MD, Associate Professor, Department of Pathology and Immunology, Washington University School of Medicine, 660 S. Euclid Ave, Campus Box 8118, 3rd Floor, Rm 3421, Institute of Health Bldg, St. Louis, MO 63110, United States.
Received: January 28, 2021
Peer-review started: January 28, 2021
First decision: February 24, 2021
Revised: March 31, 2021
Accepted: April 23, 2021
Article in press: April 23, 2021
Published online: April 28, 2021
Core Tip

Core Tip: The use of laboratory hematology data as biomarkers of disease has not been examined for coronavirus disease 2019 (COVID-19) patients with liver injury, and the clinical significance of liver injury in COVID-19 is unclear. By means of a systematic review we showed that blood cell count, absolute neutrophil count, absolute lymphocyte count (ALC), and hemoglobin are of potential use in identifying liver failure in COVID-19. ALC and d-dimer have potential utility in distinguishing severe from non-severe disease in patients with liver injury. Our findings provide a rationale for further studies with sufficiently large numbers of patients and rigorous definition of liver injury to validate these findings.