Impact of COVID-19 on Liver Functions Tests in Egyptian Patients with or without Chronic Liver Disease

Abstract

Background and aim: Impact of corona virus disease 2019 (COVID-19) on liver remains poorly characterized. Severe hepatic injury has been reported in COVID-19, even though the transaminases levels’ elevation is usually mild. We aimed to evaluate the correlation between these abnormalities and severity of COVID-19. Patients and Methods: ‎‎‎ This retrospective research was performed on COVID-19 cases. All studied cases were classified into: group 1 (n=100): cases without chronic liver disease (CLD) and group 2 (n=100): cases with CLD. Results: The mean ± SD of age was 50.57 ± 11.78 in group 1 and 55.77 ± 7.87 in group 2. Liver tests were abnormal in 41% and 55% of the subjects in group 1 and 2 respectively. Group 2 had significantly more gastrointestinal tract symptoms than group 1 (p =0.033). Alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin, direct bilirubin and international normalized ratio (INR) after infection were significantly higher than before infection in both groups (p <0.001). Group 2 had significantly higher mortality rate (47%) than group 1 (32%) (P= 0.02). MELD score was significantly higher in died patients than recovered patients in group 2 (p <0.001). After COVID-19 infection, hepatic encephalopathy (HE) and aggravation of ascites was found in 34% and 36% of patients in group 2. Conclusion: COVID-19 infection can cause liver function abnormalities in both cases with and without CLD with aggravation of ascites and HE development in cirrhotic patients.