Dynamic monitoring of serum liver function indexes in patients with COVID-19

doi:10.12998/wjcc.v9.i7.1554

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World Journal of Clinical Cases

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Retrospective Study

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.

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

ARTICLE HIGHLIGHTS

Research 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.

Research motivation

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

Research objectives

The main objectives of this retrospective trial study was to analyze the clinical significance of the dynamic monitoring of the liver function of patients with COVID-19.

Research methods

We retrospectively analyzed the liver indexes of patients diagnosed with COVID-19 in our hospital. The serum levels of alanine amino-transferase (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. We analyzed the dynamic changes in liver function index before and after treatment.

Research results

There were no significant differences found in albumin, ALT, AST, γ-glutamyltransferase, and 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.

Research conclusions

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.

Research perspectives

Close monitoring on the liver function in severe patients can allow timely intervention for liver damage, help organ function recovery, and avoid deterioration of liver function.