Dong X, Zeng DY, Xing QQ, Hong MZ, Pan JS. Liver chemistries in severe or non-severe cases of COVID-19: A systematic review and meta-analysis. World J Hepatol 2022; 14(12): 2012-2024 [PMID: 36618330 DOI: 10.4254/wjh.v14.i12.2012]
Corresponding Author of This Article
Jin-Shui Pan, MD, PhD, Chief Doctor, Professor, Department of Hepatology, The First Affiliated Hospital of Fujian Medical University, No. 20 Chazhong Road, Fuzhou 350005, Fujian Province, China. j.s.pan76@gmail.com
Research Domain of This Article
Infectious Diseases
Article-Type of This Article
Systematic Reviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Share the Article
Dong X, Zeng DY, Xing QQ, Hong MZ, Pan JS. Liver chemistries in severe or non-severe cases of COVID-19: A systematic review and meta-analysis. World J Hepatol 2022; 14(12): 2012-2024 [PMID: 36618330 DOI: 10.4254/wjh.v14.i12.2012]
World J Hepatol. Dec 27, 2022; 14(12): 2012-2024 Published online Dec 27, 2022. doi: 10.4254/wjh.v14.i12.2012
Liver chemistries in severe or non-severe cases of COVID-19: A systematic review and meta-analysis
Xuan Dong, Dan-Yi Zeng, Qing-Qing Xing, Mei-Zhu Hong, Jin-Shui Pan
Xuan Dong, Dan-Yi Zeng, Qing-Qing Xing, Jin-Shui Pan, Department of Hepatology, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, Fujian Province, China
Mei-Zhu Hong, Department of Traditional Chinese Medicine, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou 350005, Fujian Province, China
Author contributions: Pan JS and Hong MZ were involved with the study conceptualization and design; analysis and interpretation of data; drafting of the manuscript; and approval of the final version of the manuscript; Dong X, Zeng DY, and Xing QQ were involved in data retrieval; All authors read and approved the final manuscript; Dong X and Zeng DY contributed equally to this work.
Conflict-of-interest statement: All the authors declare that they have no conflict of interest.
PRISMA 2009 Checklist statement: The study only utilizes publically available published aggregated anonymous data, not a human subject research. Potential studies were retrieved in accordance with the PRISMA guideline.
Corresponding author: Jin-Shui Pan, MD, PhD, Chief Doctor, Professor, Department of Hepatology, The First Affiliated Hospital of Fujian Medical University, No. 20 Chazhong Road, Fuzhou 350005, Fujian Province, China. j.s.pan76@gmail.com
Received: July 3, 2022 Peer-review started: July 3, 2022 First decision: September 30, 2022 Revised: October 21, 2022 Accepted: December 21, 2022 Article in press: December 21, 2022 Published online: December 27, 2022 Processing time: 172 Days and 20 Hours
Abstract
BACKGROUND
Coronavirus disease (COVID-19) patients exhibit different patterns of liver impairment, according to growing evidence.
AIM
In this study, we sought to provide a comprehensive analysis of liver test parameters in patients with severe and non-severe COVID-19.
METHODS
We performed a meta-analysis of published liver manifestations and described the liver damage in COVID-19. We searched PubMed, Google Scholar, Embase, Cochrane Library, medRxiv, bioRxiv, and three Chinese electronic databases through April 18, 2020, in accordance with the Preferred Reporting Items for Meta-Analyses. We analyzed pooled data on liver chemistries stratified by COVID-19 severity using a fixed or random-effects model.
RESULTS
A meta-analysis of 56 studies, including 11052 patients, found that the pooled mean alanine aminotransferase (ALT) in severe COVID-19 cases was 35.9 IU/L whereas in non-severe COVID-19 cases was 27.3 IU/L. Average aspartate aminotransferase (AST) levels were 44.3 IU/L in severe cases compared to 27.9 IU/L in non-severe cases. In addition, AST levels are often higher than ALT levels regardless of disease severity. The severe cases tended to have a higher gamma-glutamyltransferase level but a lower albumin level than the non-severe cases.
CONCLUSION
Severe COVID-19 was more likely to be associated with abnormal liver test results. Monitoring liver chemistry closely can help detect disease progression early.
Core Tip: Data on abnormal liver chemistries related to coronavirus disease (COVID-19) are cumulating but are potentially confusing. We performed a meta-analysis of 56 studies that included a total of 11052 patients with COVID-19. We noted that patients with abnormal liver test results are at higher risk of progression to severe disease and close monitoring of liver chemistries provides early warning against disease progression.
