Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 6, 2021; 9(7): 1554-1562
Published online Mar 6, 2021. doi: 10.12998/wjcc.v9.i7.1554
Dynamic monitoring of serum liver function indexes in patients with COVID-19
Hao Lin, Ling-Jie Wu, Shun-Qi Guo, Rui-Lie Chen, Jing-Ru Fan, Bin Ke, Ze-Qun Pan
Hao Lin, Department of Gastroenterology, Shantou Central Hospital, Shantou 515000, Guangdong Province, China
Ling-Jie Wu, Rui-Lie Chen, Department of Infectious Disease, Shantou Central Hospital, Shantou 515000, Guangdong Province, China
Shun-Qi Guo, Jing-Ru Fan, Department of Emergency, Shantou Central Hospital, Shantou 515000, Guangdong Province, China
Bin Ke, Department of Ultrasonography, Shantou Central Hospital, Shantou 515000, Guangdong Province, China
Ze-Qun Pan, Department of Pediatrics, Shantou Central Hospital, Shantou 515000, Guangdong Province, China
Author contributions: Lin H contributed to data curation, methodology, validation, writing, reviewing, and editing; Lin H, Wu LJ, Guo SQ, Chen RL, Fan JR, and Ke B contributed to project administration; Pan ZQ contributed to supervision; Wu LJ contributed to writing the original draft; Wu LJ contributed to formal analysis; Pan ZQ and Lin H contributed to funding acquisition; Pan ZQ, Lin H, and Wu LJ contributed to investigation.
Supported by Shantou Science and Technology Bureau 1st Fund of the Prevention and Treatment of New Coronavirus Pneumonia, No. 2020-1-35.
Institutional review board statement: The study was approved by the ethics committee of Shantou Central Hospital [[2020]-Research No.003].
Informed consent statement: The need for individual consent was waived because of the retrospective nature of the study.
Conflict-of-interest statement: All authors declare that they have no competing interests.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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/
Corresponding author: Ze-Qun Pan, BSc, Doctor, Department of Pediatrics, Shantou Central Hospital, Shantou Central Hospital, No. 114 Waima Road, Jinping District, Shantou 515000, Guangdong Province, China. pzqkbin@126.com
Received: August 11, 2020
Peer-review started: August 11, 2020
First decision: December 14, 2020
Revised: December 18, 2020
Accepted: December 30, 2020
Article in press: December 30, 2020
Published online: March 6, 2021
Processing time: 201 Days and 19.9 Hours
Abstract
BACKGROUND

Some patients with the novel 2019 coronavirus disease (COVID-19) display elevated liver enzymes. Some antiviral drugs that can be used against COVID-19 are associated with a risk of hepatotoxicity.

AIM

To analyze the clinical significance of the dynamic monitoring of the liver function of patients with COVID-19.

METHODS

This was a retrospective study of patients diagnosed with COVID-19 in January and February 2020 at the Department of Infection, Shantou Central Hospital. The exclusion criteria for all patients were: (1) History of chronic liver disease; (2) History of kidney disease; (3) History of coronary heart disease; (4) History of malignancy; or (5) History of diabetes. The serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ-glutamyltransferase, and total bilirubin of patients with COVID-19 were measured on days 1, 3, 7 and 14 after admission, and compared to non-COVID-19 patents.

RESULTS

Twelve patients with COVID-19 (seven men and five women) and twelve controls (eight men and four women) were included. There were one, two, and nine patients with severe, mild, and moderate COVID-19, respectively. There were no differences in age and sex between the two groups (both P > 0.05). No significant differences were found in albumin, ALT, AST, γ-glutamyltransferase, or total bilirubin between the controls and the patients with COVID-19 on day 1 of hospitalization (all P > 0.05). Serum albumin showed a decreasing trend from days 0 to 7 of hospitalization, reaching the lowest level on day 7. Total bilirubin was higher on day 3 than on day 7. ALT, AST, and γ-glutamyltransferase did not change significantly over time. The severe patient was observed to have ALT levels of 67 U/L and AST levels of 75 U/L on day 7, ALT of 71 U/L and AST of 35 U/L on day 14, and ALT of 210 U/L and AST of 123 U/L on day 21.

CONCLUSION

Changes in serum liver function indicators are not obvious in the early stage of COVID-19, but clinically significant changes might be observed in severe COVID-19.

Keywords: COVID-19; Liver function; Dynamic monitoring; Disease severity; Kidney disease; Index

Core Tip: Twelve patients with 2019 coronavirus disease and twelve controls were included. There were one, two, and nine patients with severe, mild, and moderate 2019 coronavirus disease, respectively. Serum albumin showed a decreasing trend from days 0 to 7 of hospitalization, reaching the lowest level on day 7. Total bilirubin was higher on day 3 than on day 7. Alanine aminotransferase, aspartate aminotransferase, and γ-glutamyltransferase did not change significantly over time.