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2020 ; 115
(7
): 1075-1083
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Liver Enzyme Elevation in Coronavirus Disease 2019: A Multicenter, Retrospective,
Cross-Sectional Study
#MMPMID32618658
Hao SR
; Zhang SY
; Lian JS
; Jin X
; Ye CY
; Cai H
; Zhang XL
; Hu JH
; Zheng L
; Zhang YM
; Jia HY
; Yu GD
; Wang XY
; Gu JQ
; Lu YF
; Yu XP
; Yu L
; Xiang DR
; Ye CY
; Jin CL
; Qiu YQ
; Li LJ
; Sheng JF
; Liang TB
; Yang YD
Am J Gastroenterol
2020[Jul]; 115
(7
): 1075-1083
PMID32618658
show ga
INTRODUCTION: Elevated liver enzyme levels are observed in patients with
coronavirus disease 2019 (COVID-19); however, these features have not been
characterized. METHODS: Hospitalized patients with COVID-19 in Zhejiang Province,
China, from January 17 to February 12, 2020, were enrolled. Liver enzyme level
elevation was defined as alanine aminotransferase level >35 U/L for men and 25
U/L for women at admission. Patients with normal alanine aminotransferase levels
were included in the control group. Reverse transcription polymerase chain
reaction was used to confirm severe acute respiratory syndrome coronavirus 2
(SARS-CoV-2) infection, and patients symptomatic with SARS-CoV-2 infection were
defined as patients with COVID-19. Epidemiological, demographic, clinical,
laboratory, treatment, and outcome data were collected and compared. RESULTS: Of
788 patients with COVID-19, 222 (28.2%) patients had elevated liver enzyme levels
(median [interquartile range {IQR}] age, 47.0 [35.0-55.0] years; 40.5% women).
Being male, overweight, and smoking increased the risk of liver enzyme level
elevation. The liver enzyme level elevation group had lesser pharyngalgia and
more diarrhea than the control group. The median time from illness onset to
admission was 3 days for liver enzyme level elevation groups (IQR, 2-6), whereas
the median hospitalization time for 86 (38.7%) discharged patients was 13 days
(IQR, 11-16). No differences in disease severity and clinical outcomes were noted
between the groups. DISCUSSION: We found that 28.2% of patients with COVID-19
presented with elevated liver enzyme levels on admission, which could partially
be related to SARS-CoV-2 infection. Male patients had a higher risk of liver
enzyme level elevation. With early medical intervention, liver enzyme level
elevation did not worsen the outcomes of patients with COVID-19.