Post COVID-19 infection: Long-term effects on liver and kidneys

Table 1 Studies showing liver function abnormalities in coronavirus disease 2019 patients

No.	Study	Finding	Ref.
1	Large scale study: n = 1099	AST/ALT were elevated in 18.2%/19.8% of mild COVID-19 patientsand 39.4%/28.1% in severe COVID-19 patients	Guan et al[7]
2	Small scale study: n = 41	AST was elevated in 62% of patients in the ICU compared with 25% in those who did not require care in the ICU	Huang et al[8]
3	n = 99	AST (U/L): All patients: 34 (26-48); ALT (U/L): All patients: 39 (21-55)	Chen et al[17]
4	n = 113	AST (U/L): All patients: 16 (22-46); ALT (U/L): All patients: 22%; Deaths: 27%	Chen et al[25]
5	n = 115	AST (U/L): All patients: 28.3 ± 15.6; ULN ≤ 50 U/L: 85%; 50-150 U/L: 15%; > 150: None; ALT (U/L): All patients: 34 (18-67); Moderate: 28 (21-43.5); Severe: 36.5 (17.5-71.5)	Zhang et al[30]
6	French Cohort Study, n = 281 patients	102 (36.3%) patients had liver dysfunctions. High level of GGT was the most common perturbation (25.3%). Elevated levels of AST (24.3%) and ALT (12.8%)	Chaibi et al[81]
7	Large scale study: China, n = 350	ALT (U/L) and AST (U/L) were profoundly elevated in critically ill patients (33; 49) in comparison to severe patients (23; 29) and mild patients (22; 26)	Fu et al[82]
8	n = 79	AST (U/L): All patients: 30 (20-50); Moderate: 28 (22-48); Severe: 35 (22-55). ALT (U/L): All patients: 34 (18-67); Moderate: 28 (21-43.5); Severe: 36.5 (17.5-71.5)	Xie et al[83]
9	n = 104	ALT (U/L) and AST (U/L) were profoundly elevated in patients (36.5; 33)	Li et al[84]
10	Large scale study: China, n = 657	ALT (U/L) was highly elevated in critically ill patients (41) in comparison to moderate patients (25)	Wang et al[85]
11	Large scale study: China, n = 1827	AST (U/L): Abnormal in pre-hospitalization patients (20.3%); Admission (66.9%) and peak hospitalization (83.4%) patients with COVID-19; ALT (U/L): Abnormal in pre-hospitalization patients (19.1%); Admission (41.6%) and peak hospitalization (61.6%) patients with COVID-19 infection	Hundt et al[86]
12	Large scale study: New York, n = 5700	58.4% developed AST values > 40U/L and 39% ALT > 60U/L. 56 patients (2.1%) developed acute hepatic injury defined as an elevation in AST or ALT of >15 times the upper limit of normal	Richardson et al[87]

ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; COVID-19: Coronavirus disease 2019; GGT: Gamma-glutamyl transferase; ICU: Intensive care unit; ULN: Upper limit of normal.

Table 2 Studies showing kidney abnormalities in coronavirus disease 2019 patients

No.	Study	Finding	Ref.
1	n = 191 patients; 137 were discharged and 54 died in hospital	The incidence of AKI was in 15% in the COVID-19 infected patients, out of which 50% were non-survivors and 1% were survivors	Zhou et al[2]
2	n = 41 patients	10% patients had elevated creatinine level (> 133 μmol/L) on admission and 7% had AKI. Incidence rate was further increased to 23% in critically ill patients in ICU	Huang et al[8]
3	n = 193 patients	After hospital admission, 59% of patients developed proteinuria, 44% with haematuria, 14% with increased levels of blood urea nitrogen, and 10% with increased levels of serum creatinine	Li et al[46]
4	n = 701 consecutive hospitalized patients	11.9% of those with elevated baseline creatinine developed AKI compared to 4.0% in patients with normal baseline creatinine. 44% of patients had proteinuria and haematuria. Mortality rate was higher in patients with proteinuria, haematuria, elevated baseline creatinine and urea, and AKI stage 2-3	Cheng et al[47]
5	Observational study of n = 287 patients	Most patients recover from AKI stage 1. Patients who progress to AKI stage 2 or 3 have a very high mortality rate	Xiao et al[53]
6	Retrospective study of n = 333 patients	About 75% experienced urine dipstick abnormalities or AKI. Patients who presented kidney dysfunction had higher mortality rates (11.2%) than patients without kidney involvement (1.2%)	Pei et al[88]
7	Observational study of n = 5449 hospitalized patients	The incidence of AKI was 36.6% with 14.3% of patients requiring dialysis. It was higher in patients admitted to the ICU. Patients with AKI had higher mortality compared to those without AKI (35% and 16.3%, respectively)	Hirsch et al[89]
8	n = 116 patients	Most of the patients with AKI were critical (52.4%) and incidence of AKI was 18.1% among patients admitted with COVID-19	Cui et al[90]

AKI: Acute kidney injury; COVID-19: Coronavirus disease 2019; ICU: Intensive care unit.