Changes in liver enzymes and association with prognosis in patients with COVID-19: a retrospective case-control study

J Int Med Res. 2022 Jul;50(7):3000605221110067. doi: 10.1177/03000605221110067.

Abstract

Objective: COVID-19 has recently emerged as a serious threat to global health. This study examined the laboratory investigations of patients with COVID-19, with an emphasis on liver enzymes.

Methods: This retrospective, single-center study was performed on patients with COVID-19 who were admitted to Imam Reza Hospital, Iran from March 2020 to February 2021. Laboratory tests included a complete blood cell count, white blood cell (WBC) count, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), lymphocyte/monocyte ratio, and levels of aspartate aminotransferase, alanine aminotransferase (ALT), and alkaline phosphatase. Patient survival was among the outcome measures investigated in association with laboratory findings.

Results: We enrolled 77 patients with COVID-19 and 63 healthy controls. In comparison with the control group, patients with COVID-19 showed COVID-19 increased ALT, WBC, neutrophils, NLR, and PLR, and decreased platelet counts and lymphocytes.

Conclusion: Although elevated levels of AST, NLR, PLR, and LMR were found in patients with COVID-19, they were not linked to mortality. Given the presence of AST in other tissues, the influence of SARS-CoV-2 on the liver should be interpreted with caution.

Keywords: COVID-19; SARS-CoV-2; case–control study; liver disease; liver enzyme; liver injury.

MeSH terms

  • Blood Platelets
  • COVID-19*
  • Case-Control Studies
  • Humans
  • Liver
  • Lymphocytes
  • Neutrophils
  • Prognosis
  • Retrospective Studies
  • SARS-CoV-2