Effect of COVID-19 on liver abnormalities: a systematic review and meta-analysis

Sci Rep. 2021 May 19;11(1):10599. doi: 10.1038/s41598-021-89513-9.

Abstract

Emerging evidence suggest association of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection with the development of many liver abnormalities. The overarching aim of this study was therefore to assess the available evidence on the clinical effects of SARS-CoV-2 on the profiles of liver chemistries and coagulation in COVID-19 diagnosed patients. We considered all study designs including epidemiological and observational that reported liver function test abnormalities in patients confirmed with SARS-CoV-2 infection. Medline, Embase databases and Google Scholar as well as relevant reviews were searched to identify appropriate studies from inception to 31st of August 2020. We calculated the pooled mean with 95% confidence intervals (95% CI) through a random-effect model meta-analysis. A total of 35 studies with 10,692 participants were considered for the review from which 23 studies with sufficient quantitative data were included in the meta-analysis. The pooled mean for liver enzymes and coagulation parameters did not significantly change in patients diagnosed with COVID-19 and remained within normal range. Notwithstanding potential bias from confounding factors in interpretation of data in this review, findings from the observational studies and case reports suggest that COVID-19 does not appear to have a significant impact on the transaminases or total bilirubin levels of patients with confirmed SARS-CoV-2 infection. Further controlled studies and larger sample size observational studies are needed with adequate reporting of other liver function parameters are warranted.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • COVID-19 / pathology*
  • COVID-19 / virology
  • Humans
  • Liver Diseases / epidemiology
  • Liver Diseases / pathology*
  • Liver Diseases / virology*
  • Liver Function Tests
  • SARS-CoV-2 / isolation & purification
  • SARS-CoV-2 / pathogenicity