Scientific Reports (Oct 2020)

High aspartate aminotransferase to alanine aminotransferase ratio on admission as risk factor for poor prognosis in COVID-19 patients

  • Cheng Qin,
  • Yingxin Wei,
  • Xiaoyu Lyu,
  • Bangbo Zhao,
  • Yunlu Feng,
  • Tianhao Li,
  • Hongtao Cao,
  • Xiaoying Yang,
  • Xingtong Zhou,
  • Weibin Wang,
  • Lei You,
  • Yujun Wang

DOI
https://doi.org/10.1038/s41598-020-73575-2
Journal volume & issue
Vol. 10, no. 1
pp. 1 – 10

Abstract

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Abstract This study aimed to analyze aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio in COVID-19 patients. After exclusion, 567 inpatients were included in this study and separated into two groups according to their AST/ALT ratio on admission. Death was regarded as poor prognosis in this study. Of 567 patients, 200 (35.3%) had AST/ALT ≥ 1.38. Of the 200 patients, older age (median age 60 years), myalgia (64 [32%] cases), fatigue (91 [45.5%] cases), some comorbidities and outcomes were significantly different from patients with AST/ALT < 1.38. They also had worse chest computed tomography (CT) findings, laboratory results and severity scores. Levels of platelet count (OR 0.995, 95% CI [0.992–0.998]) and hemoglobin (OR 0.984, 95% CI [0.972–0.995]) were independently associated with AST/ALT ≥ 1.38 on admission. Furthermore, a high AST/ALT ratio on admission was an independent risk factor for poor prognosis (OR 99.9, 95% CI [2.1–4280.5]). In subsequent monitoring, both survivors and non-survivors showed decreased AST/ALT ratio during hospitalization. In conclusion, high AST/ALT ratio might be the indication of worse status and outcomes in COVID-19 patients.