Elevated serum aspartate aminotransferase level identifies patients with coronavirus disease 2019 and predicts the length of hospital stay

J Clin Lab Anal. 2020 Jul;34(7):e23391. doi: 10.1002/jcla.23391. Epub 2020 Jun 2.


Background: Coronavirus disease 2019 (COVID-19) has become a worldwide public health emergency. This study aimed to investigate the clinical significance of liver blood tests in COVID-19 patients.

Methods: The analysis included clinical data of 23 patients with suspected COVID-19 and 66 patients with confirmed COVID-19 from January 25 to February 20, 2020. The relationship between liver blood test results, liver condition (HBsAb positive, HBcAb positive, and fatty liver disease), and duration of hospital stay among COVID-19 patients was analyzed.

Results: The median hospital stay of COVID-19 patients was 6 days. Serum albumin (Alb) level was lower in patients with COVID-19 confirmed on admission than in patients with suspected COVID-19 (40.08 g/L vs 42.50 g/L, P = .016), while the level of aspartate aminotransferase (AST) was higher (23 U/L vs 18 U/L, P = .005). Abnormal results of liver blood tests in patients with COVID-19 included increased levels of alanine transaminase (ALT) (21.2%, 14 patients), AST (15.2%, 10 patients), and gamma-glutamyl transpeptidase (GGT) (22.7%, 15 patients). After 5-10 days of treatment, levels of Alb and AST in COVID-19 patients were significantly decreased (P < .001 and P = .027, respectively). Abnormal levels of Alb and AST in patients with COVID-19 were not associated with the liver condition (all P > .05). In addition, only levels of AST were positively correlated with the duration of hospital stay (r = .334, P = .007).

Conclusion: Abnormal results of the liver blood test were found in COVID-19 patients. The COVID-19 patients on admission with the higher levels of AST might have longer hospital stays.

Keywords: COVID-19; aspartate aminotransferase; fatty liver disease; hospital stay; liver blood test.

MeSH terms

  • Adult
  • Aspartate Aminotransferases / blood*
  • Betacoronavirus / physiology*
  • COVID-19
  • Coronavirus Infections / blood*
  • Coronavirus Infections / enzymology*
  • Coronavirus Infections / therapy
  • Coronavirus Infections / virology
  • Female
  • Humans
  • Length of Stay*
  • Liver / virology
  • Liver Function Tests
  • Male
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral / blood*
  • Pneumonia, Viral / enzymology*
  • Pneumonia, Viral / therapy
  • Pneumonia, Viral / virology
  • SARS-CoV-2


  • Aspartate Aminotransferases