Review of Liver Enzymes Abnormalities in Patients with SARS-CoV-2 Infection

Waseem F. Al Tameemi; Anas Habeeb Mohammed Matar Al-Sharqi

doi:doi:10.11648/j.ajim.20221001.11

| Peer-Reviewed

Review of Liver Enzymes Abnormalities in Patients with SARS-CoV-2 Infection

Waseem F. Al Tameemi, Anas Habeeb Mohammed Matar Al-Sharqi

Published in American Journal of Internal Medicine (Volume 10, Issue 1)

Received: 10 November 2021 Accepted: 30 November 2021 Published: 8 January 2022

Views: Downloads:

Download PDF

Share This Article

Twitter
Linked In
Facebook

Abstract

Background: Liver function derangements have been reported in COVID-19, but reported rates are variable. Treatment in intensive care units (ICU) has become a major challenge; therefore, early recognition of severe and critical cases is absolutely essential for timely triaging of patients. Objectives: to review incidence of acute liver injury in patients with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Patients and methods: obtaining clinical records and laboratory results prospectively from one hundred patients with PCR-confirmed or radiography-confirmed COVID-19, who are admitted to the isolation wards and emergency departments of three different hospitals in Baghdad from 1st of December 2020 to 31st of March 2021. Results: The mean age group of study sample was (61.2±12.36) years, males formed 59%. GI manifestations were recorded in 47% of total cases, and were statistically correlated with disease severity (P value 0.001). Wide range of LFT abnormalities are found in patients with COVID-19, but none of which showed statistical significance in relation to disease severity. When LFT results were reviewed in relation to previous comorbidities, GGT was found to be statistically correlated with the underlying CLD (P value 0.001), and ALP with both underlying CLD and DM (P values <0.001 and 0.029, respectively) and even in the absence of underlying comorbidity (P value 0.006). Conclusion: Liver enzyme derangements are increasingly reported in patients with COVID-19, but are not necessarily correlate with disease severity. Cholestatic picture of liver enzyme derangement is a more commonly recorded manifestation.

Published in	American Journal of Internal Medicine (Volume 10, Issue 1)
DOI	10.11648/j.ajim.20221001.11
Page(s)	1-7
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

COVID-19, SARS-CoV-2, Hepatitis, Liver Enzymes, Cholestasis

References

[1]	Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020 Feb 15; 395 (10223): 497-506. Full text (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30183-5/fulltext).
[2]	Li J, Fan J. Characteristics and Mechanism of Liver Injury in 2019 Coronavirus Disease. J of Clinical and Translational Hepatology. 2020; 8: 13-17. (http://www.ncbi.nim.nih.gov/pmc/articles/PMC7133031).
[3]	Nardo AD, Schneeweiss-Gleixner M, et al. Pathophysiological mechanisms of liver injury in COVID-19. Liver Int. 2021; 41: 20–32. (https://doi.org/10.1111/liv.14730).
[4]	Perlman, S.; Netland, J. Coronaviruses post-SARS: Update on replication and pathogenesis. Nat. Rev. Microbiol. 2009, 7, 439–450. (https://www.nature.com/articles/nrmicro2147).
[5]	Kucharski AJ, Russell TW, Diamond C, et al. Early dynamics of transmission and control of COVID-19: a mathematical modelling study. Lancet Infect Dis. 2020; 20: 553-558. (https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30144-4/fulltext).
[6]	Piplani S, Singh PK, Winkler DA, et al; arXiv. In silico comparison of spike protein-ACE2 binding affinities across species; significance for the possible origin of the SARS-CoV-2 virus. 2020 [internet publication]. (https://arxiv.org/abs/2005.06199).
[7]	Goshua G, Pine AB, Meizlish ML, et al. Endotheliopathy in COVID-19-associated coagulopathy: evidence from a single-centre, cross-sectional study. Lancet Haematol. 2020 Aug; 7 (8): e575-82. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7326446/).
[8]	Rabiee A, Sadowski B, et al. Liver Injury in Liver Transplant Recipients with Coronavirus Disease 2019 (COVID-19): US Multicenter Experience. Hepatology. 2020; 72: 1900-11. (https://aasldpubs.onlinelibrary.wiley.com/doi/full/10.1002/hep.31574).
[9]	European Association for the Study of the Liver Clinical Practice Guideline Panel: Chair: Panel members EASL Governing Board representative. Clinical Practice Guidelines: Drug-induced liver injury. Clinical Practice Guidelines. 2019; 70: (6): 1222–1261. DOI: https://doi.org/10.1016/j.jhep.2019.02.014
[10]	Yang R, Li X, Liu H, et al. Chest CT severity score: An Imaging tool for assessing Severe COVID-19. Radiology: Cardiothoracic Imaging 2020; 2 (2): e200047-7. (https://pubs.rsna.org/doi/10.1148/ryct.2020200047).
[11]	Rubin SJS, Falkson SR, Degner NR, et al. Clinical characteristics associated with COVID-19 severity in California. Journal of Clinical and Translational Science 2020; 5: e3, 1-4. (https://www.cambridge.org/core/journals/journal-of-clinical-and-translational-science/article/clinical-characteristics-associated-with-covid19-severity-in-california/B58EB9C431C6404D867BF70DBCAEBA19).
[12]	Chai X, Hu L, Zhang Y, et al. Specific ACE2 expression in cholangiocytes amy cause liver damage after 2019-nCOV infection. bioRvix 2020: 7. (https://doi.org/10.1101/2020.02.03.941766).
[13]	Alqahtani S, Schattenberg J. Liver Injury in COVID-19: The current evidence. United European Gastroenterology Journal. 2020; 8 (5): 509-19. (https://onlinelibrary.wiley.com/doi/10.1177/2050640620924157).
[14]	Tian S, Xiong Y, Liu H, et al. Pathological study of the 2019 novel coronavirus disease (COVID-19) through postmortem core biopsies. Modern Pathology 2020; 33: 1010. (https://www.nature.com/articles/s41379-020-0536-x).
[15]	Lau G, Sharma M. Clinical practice guidance for hepatology and liver transplant providers during the COVID-19 pandemic: APASL expert panel consensus recommendations. Hepatology int. 2020: 4. (https://doi.org/10.1007/s12072-020-10054-w).
[16]	Cao P, Wu Y, et al. Elevated serum ferritin level effectively discriminates severity illness and liver injury of coronavirus disease 2019 pneumonia. Biomarkers 2020: 6. (https://doi.org/10.1080/1354750X.2020.1861098).

Cite This Article

Plain Text BibTeX RIS

APA Style

Waseem F. Al Tameemi, Anas Habeeb Mohammed Matar Al-Sharqi. (2022). Review of Liver Enzymes Abnormalities in Patients with SARS-CoV-2 Infection. American Journal of Internal Medicine, 10(1), 1-7. https://doi.org/10.11648/j.ajim.20221001.11

Copy | Download

ACS Style

Waseem F. Al Tameemi; Anas Habeeb Mohammed Matar Al-Sharqi. Review of Liver Enzymes Abnormalities in Patients with SARS-CoV-2 Infection. Am. J. Intern. Med. 2022, 10(1), 1-7. doi: 10.11648/j.ajim.20221001.11

Copy | Download

AMA Style

Waseem F. Al Tameemi, Anas Habeeb Mohammed Matar Al-Sharqi. Review of Liver Enzymes Abnormalities in Patients with SARS-CoV-2 Infection. Am J Intern Med. 2022;10(1):1-7. doi: 10.11648/j.ajim.20221001.11

Copy | Download

@article{10.11648/j.ajim.20221001.11,
  author = {Waseem F. Al Tameemi and Anas Habeeb Mohammed Matar Al-Sharqi},
  title = {Review of Liver Enzymes Abnormalities in Patients with SARS-CoV-2 Infection},
  journal = {American Journal of Internal Medicine},
  volume = {10},
  number = {1},
  pages = {1-7},
  doi = {10.11648/j.ajim.20221001.11},
  url = {https://doi.org/10.11648/j.ajim.20221001.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajim.20221001.11},
  abstract = {Background: Liver function derangements have been reported in COVID-19, but reported rates are variable. Treatment in intensive care units (ICU) has become a major challenge; therefore, early recognition of severe and critical cases is absolutely essential for timely triaging of patients. Objectives: to review incidence of acute liver injury in patients with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Patients and methods: obtaining clinical records and laboratory results prospectively from one hundred patients with PCR-confirmed or radiography-confirmed COVID-19, who are admitted to the isolation wards and emergency departments of three different hospitals in Baghdad from 1st of December 2020 to 31st of March 2021. Results: The mean age group of study sample was (61.2±12.36) years, males formed 59%. GI manifestations were recorded in 47% of total cases, and were statistically correlated with disease severity (P value 0.001). Wide range of LFT abnormalities are found in patients with COVID-19, but none of which showed statistical significance in relation to disease severity. When LFT results were reviewed in relation to previous comorbidities, GGT was found to be statistically correlated with the underlying CLD (P value 0.001), and ALP with both underlying CLD and DM (P values Conclusion: Liver enzyme derangements are increasingly reported in patients with COVID-19, but are not necessarily correlate with disease severity. Cholestatic picture of liver enzyme derangement is a more commonly recorded manifestation.},
 year = {2022}
}

Copy | Download

TY  - JOUR
T1  - Review of Liver Enzymes Abnormalities in Patients with SARS-CoV-2 Infection
AU  - Waseem F. Al Tameemi
AU  - Anas Habeeb Mohammed Matar Al-Sharqi
Y1  - 2022/01/08
PY  - 2022
N1  - https://doi.org/10.11648/j.ajim.20221001.11
DO  - 10.11648/j.ajim.20221001.11
T2  - American Journal of Internal Medicine
JF  - American Journal of Internal Medicine
JO  - American Journal of Internal Medicine
SP  - 1
EP  - 7
PB  - Science Publishing Group
SN  - 2330-4324
UR  - https://doi.org/10.11648/j.ajim.20221001.11
AB  - Background: Liver function derangements have been reported in COVID-19, but reported rates are variable. Treatment in intensive care units (ICU) has become a major challenge; therefore, early recognition of severe and critical cases is absolutely essential for timely triaging of patients. Objectives: to review incidence of acute liver injury in patients with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Patients and methods: obtaining clinical records and laboratory results prospectively from one hundred patients with PCR-confirmed or radiography-confirmed COVID-19, who are admitted to the isolation wards and emergency departments of three different hospitals in Baghdad from 1st of December 2020 to 31st of March 2021. Results: The mean age group of study sample was (61.2±12.36) years, males formed 59%. GI manifestations were recorded in 47% of total cases, and were statistically correlated with disease severity (P value 0.001). Wide range of LFT abnormalities are found in patients with COVID-19, but none of which showed statistical significance in relation to disease severity. When LFT results were reviewed in relation to previous comorbidities, GGT was found to be statistically correlated with the underlying CLD (P value 0.001), and ALP with both underlying CLD and DM (P values Conclusion: Liver enzyme derangements are increasingly reported in patients with COVID-19, but are not necessarily correlate with disease severity. Cholestatic picture of liver enzyme derangement is a more commonly recorded manifestation.
VL  - 10
IS  - 1
ER  -

Copy | Download

Author Information

Waseem F. Al Tameemi

Department of Scholarships and Cultural Relations, Ministry of Higher Education and Scientific Research, Baghdad, Iraq
Anas Habeeb Mohammed Matar Al-Sharqi

Al-Immamain Al-Kadhumein Medical City, Baghdad, Iraq

Download PDF

Sections

Plain Text BibTeX RIS

APA Style

Waseem F. Al Tameemi, Anas Habeeb Mohammed Matar Al-Sharqi. (2022). Review of Liver Enzymes Abnormalities in Patients with SARS-CoV-2 Infection. American Journal of Internal Medicine, 10(1), 1-7. https://doi.org/10.11648/j.ajim.20221001.11

Copy | Download

ACS Style

Waseem F. Al Tameemi; Anas Habeeb Mohammed Matar Al-Sharqi. Review of Liver Enzymes Abnormalities in Patients with SARS-CoV-2 Infection. Am. J. Intern. Med. 2022, 10(1), 1-7. doi: 10.11648/j.ajim.20221001.11

Copy | Download

AMA Style

Waseem F. Al Tameemi, Anas Habeeb Mohammed Matar Al-Sharqi. Review of Liver Enzymes Abnormalities in Patients with SARS-CoV-2 Infection. Am J Intern Med. 2022;10(1):1-7. doi: 10.11648/j.ajim.20221001.11

Copy | Download

@article{10.11648/j.ajim.20221001.11,
  author = {Waseem F. Al Tameemi and Anas Habeeb Mohammed Matar Al-Sharqi},
  title = {Review of Liver Enzymes Abnormalities in Patients with SARS-CoV-2 Infection},
  journal = {American Journal of Internal Medicine},
  volume = {10},
  number = {1},
  pages = {1-7},
  doi = {10.11648/j.ajim.20221001.11},
  url = {https://doi.org/10.11648/j.ajim.20221001.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajim.20221001.11},
  abstract = {Background: Liver function derangements have been reported in COVID-19, but reported rates are variable. Treatment in intensive care units (ICU) has become a major challenge; therefore, early recognition of severe and critical cases is absolutely essential for timely triaging of patients. Objectives: to review incidence of acute liver injury in patients with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Patients and methods: obtaining clinical records and laboratory results prospectively from one hundred patients with PCR-confirmed or radiography-confirmed COVID-19, who are admitted to the isolation wards and emergency departments of three different hospitals in Baghdad from 1st of December 2020 to 31st of March 2021. Results: The mean age group of study sample was (61.2±12.36) years, males formed 59%. GI manifestations were recorded in 47% of total cases, and were statistically correlated with disease severity (P value 0.001). Wide range of LFT abnormalities are found in patients with COVID-19, but none of which showed statistical significance in relation to disease severity. When LFT results were reviewed in relation to previous comorbidities, GGT was found to be statistically correlated with the underlying CLD (P value 0.001), and ALP with both underlying CLD and DM (P values Conclusion: Liver enzyme derangements are increasingly reported in patients with COVID-19, but are not necessarily correlate with disease severity. Cholestatic picture of liver enzyme derangement is a more commonly recorded manifestation.},
 year = {2022}
}

Copy | Download

TY  - JOUR
T1  - Review of Liver Enzymes Abnormalities in Patients with SARS-CoV-2 Infection
AU  - Waseem F. Al Tameemi
AU  - Anas Habeeb Mohammed Matar Al-Sharqi
Y1  - 2022/01/08
PY  - 2022
N1  - https://doi.org/10.11648/j.ajim.20221001.11
DO  - 10.11648/j.ajim.20221001.11
T2  - American Journal of Internal Medicine
JF  - American Journal of Internal Medicine
JO  - American Journal of Internal Medicine
SP  - 1
EP  - 7
PB  - Science Publishing Group
SN  - 2330-4324
UR  - https://doi.org/10.11648/j.ajim.20221001.11
AB  - Background: Liver function derangements have been reported in COVID-19, but reported rates are variable. Treatment in intensive care units (ICU) has become a major challenge; therefore, early recognition of severe and critical cases is absolutely essential for timely triaging of patients. Objectives: to review incidence of acute liver injury in patients with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Patients and methods: obtaining clinical records and laboratory results prospectively from one hundred patients with PCR-confirmed or radiography-confirmed COVID-19, who are admitted to the isolation wards and emergency departments of three different hospitals in Baghdad from 1st of December 2020 to 31st of March 2021. Results: The mean age group of study sample was (61.2±12.36) years, males formed 59%. GI manifestations were recorded in 47% of total cases, and were statistically correlated with disease severity (P value 0.001). Wide range of LFT abnormalities are found in patients with COVID-19, but none of which showed statistical significance in relation to disease severity. When LFT results were reviewed in relation to previous comorbidities, GGT was found to be statistically correlated with the underlying CLD (P value 0.001), and ALP with both underlying CLD and DM (P values Conclusion: Liver enzyme derangements are increasingly reported in patients with COVID-19, but are not necessarily correlate with disease severity. Cholestatic picture of liver enzyme derangement is a more commonly recorded manifestation.
VL  - 10
IS  - 1
ER  -

Copy | Download