Study on liver disease in COVID-19 and its association with COVID disease severity and mortality

Abstract

Background: COVID-19, a respiratory illness caused by SARS-CoV-2virus, has been implicated in hepatic injury. Abnormal liver function tests are found in 14-53% of COVID-19 cases. Objectives: Present study was conducted to study the spectrum of hepatic injury and its association with COVID-19 disease severity among patients aged ≥18 years treated at a tertiary care hospital in Central Karnataka. Methods: It was a retrospective study based on review of medical records of diagnosed COVID-19 patients aged ≥18 years treated on in-patient basis at a tertiary care hospital. Patients’ COVID disease severity and in-hospital outcomes were noted. Presence of COVID associated hepatic injury such as hepatocellular, cholestatic and mixed type liver injuries were documented. Results: Severe COVID-19 disease and death rates were significantly higher among patients with COVID-19 associated Hepatic injury’ (73.1%, 46.3% respectively). Inflammatory markers such as D-dimer, CRP, LDH and Ferritin were significantly elevated in ‘COVID-19 associated Hepatic injury (Q2: 442ng/ml, 07mg/dl, 588U/L, 838ng/ml respectively). Conclusion: Hepatic injuries in COVID patients are due to SARS-CoV-2 associated inflammation and were significantly associated with severe COVID disease and mortality. For physicians at Emergency Department, it gives crucial information to decide whether patient requires hospital admission or scheduled outpatient re-evaluation.

Keywords

• liver disease
• severe covid-19 disease
• mortality
• covid-19 associated hepatic injury