Impact of COVID-19 on Liver Enzymes: A Retrospective Study

Introduction: The global pandemic of novel Coronavirus Disease- 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) has spread worldwide crippling the healthcare system. Besides the respiratory system, COVID-19 patients show signs of various degrees of liver damage, the mechanism and implication yet undeciphered. Hence, in this study, we aim to find out pattern and trend of derangement in liver functions in COVID-19 patients. Aim: To depict the pattern and trend of liver enzymes in COVID- 19 admitted patients without history of liver disease. Materials and Methods: The study was conducted as a single centred, retrospective, observational study, from June 2020 till December 2020. It included 1909 admitted COVID-19 positive patients diagnosed via either nasopharyngeal or oropharyngeal swab by Real-Time Reverse Transcription-Polymerase Chain Reaction (RT-PCR). The COVID-19 positive patients were divided into four groups Group I: Age- 15-20 years; 150 patients, Group II: Age 21-40 years; 645 patients, Group III: Age 41-60 years; 560 patients, Group IV: Age >60 years; 554 patients. Abnormality in liver tests was defined as greater than three times of upper limit of normal reference range Alanine Transaminase (ALT) >120 U/L, Aspartate Transaminase (AST) >120 U/L as Hepatocellular injury, greater than two times of upper limit of normal reference range Alkaline Phosphatase (ALP) >250 U/L as Cholestatic Injury (CSI). The statistical analysis was done by the Statistical Package for Social Sciences (SPSS) version 25.0. Results: It was found that with respect to ALT levels, males in age 21-60 years, whereas females in two extremes of age 15-20 and >60 years age were the most affected. Whereas, females in age group <40 years were more affected with higher AST activity. With respect to abnormal ALP levels female in age group <40 years were most affected but males were most affected in age group >40 years. Conclusion: Irrespective of age and gender, abnormality in liver enzymes was observed. Liver Function Tests (LFT) are a part of routine investigations carried out at the time of admission; its abnormalities may guide us in devising strategy to prioritise patient management in correlation with inflammatory markers.