Liver impairment in COVID-19 patients: A retrospective analysis of 115 cases from a single centre in Wuhan city, China

Liver Int. 2020 Sep;40(9):2095-2103. doi: 10.1111/liv.14455. Epub 2020 Apr 28.


Background: The SARS-CoV-2 pandemic is an ongoing global health emergency. The aim of our study was to investigate the changes of liver function and its clinical significance in COVID-19 patients.

Method: This retrospective, single-centre study was conducted on 115 confirmed cases of COVID-19 in Zhongnan hospital of Wuhan University from 18 January 2020 to 22 February 2020. Liver function and related indexes were analysed to evaluate its relationship with disease progression in COVID-19 patients.

Results: Part of the COVID-19 patients presented with varying degrees of abnormality in liver function indexes. However, the levels of ALT, AST, TBIL, GGT and LDH in COVID-19 patients were not significantly different when compared with hospitalised community-acquired pneumonia patients, and the levels of albumin is even significantly higher. The levels of ALT, AST, TBIL, LDH and INR showed statistically significant elevation in severe COVID-19 cases compared with that in mild cases. However, the clinical significance of the elevation is unremarkable. Majority of severe COVID-19 patients showed significantly decreasing in albumin level and continuously decreasing in the progress of illness. Most of the liver function indexes in COVID-19 patients were correlated with CRP and NLR, the markers of inflammation. Logistic regression analysis further identified NLR as the independent risk factor for severe COVID-19, as well as age.

Conclusions: Although abnormalities of liver function indexes are common in COVID-19 patients, the impairment of liver function is not a prominent feature of COVID-19, and also may not have serious clinical consequences.

Keywords: COVID-19; SARS-CoV-2; Wuhan; clinical significance; liver function.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Betacoronavirus
  • C-Reactive Protein / metabolism
  • COVID-19
  • Coronavirus Infections / blood
  • Coronavirus Infections / pathology
  • Coronavirus Infections / physiopathology*
  • Female
  • Humans
  • Intensive Care Units
  • Liver / enzymology
  • Liver / pathology
  • Liver / physiopathology*
  • Liver Function Tests
  • Logistic Models
  • Lymphocyte Count
  • Male
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral / blood
  • Pneumonia, Viral / pathology
  • Pneumonia, Viral / physiopathology*
  • Retrospective Studies
  • SARS-CoV-2
  • Young Adult


  • C-Reactive Protein