Transient Aggravating Effect of COVID-19 Disease on Liver Function Parameters of Patients Hospitalized in the Intensive Care Unit

INTRODUCTION: In late December 2019, China's local office of the World Health Organization (WHO) reported a case of pneumonia of unknown cause in Wuhan City. In January 2020, the disease caused by 2019-nCoV was defined as COVID-19. Some reports stated that more than half of COVID-19 patients have liver disease of varying degrees. We hypothesized that liver injury might be common in Intensive Care Unit (ICU) patients. The current study scrutinized the changes in the liver function tests alanine transaminase (ALT), aspartate transaminase (AST), and total bilirubin in patients with and without COVID-19 admitted to the ICU at University Hospital.
METHODS: There were 100 patients diagnosed with COVID-19 and 80 non-COVID-19 patients who were admitted to the ICU in this retrospective study. The study was conducted between March 15, 2020, and November 15, 2021 (20 months). Inclusion criteria for the control (n=80) and study groups (n=100) were to be older than 18 years of age and not have any liver disease. In addition, another inclusion criterion for the study group was having a diagnosis of COVID-19. AST, ALT, and total bilirubin results were obtained from a data recording system named “Pusula” used in Medipol Mega University Hospital. Data was analyzed by GraphPad Prism v. 5.0 statistical program, and p<0.05 was considered statistically significant.
RESULTS: Findings demonstrated that ALT and AST levels were significantly higher in patients with COVID-19 when compared with patients without COVID-19 (p<0.05). Total bilirubin was also observed as elevated in patients with COVID-19. However, this elevation was not significant (p>0.05).
DISCUSSION AND CONCLUSION: In conclusion, it can be stated that COVID-19 may cause hepatosteatosis resulting in liver damage. However, further studies are needed to elucidate possible mechanisms of liver injury in COVID-19 patients and their significance for clinical prognosis.