Increased Serum Aminotransferase Activity and Clinical Outcomes in Coronavirus
Disease 2019
#MMPMID32837096
Ramachandran P
; Perisetti A
; Gajendran M
; Chakraborti A
; Narh JT
; Goyal H
J Clin Exp Hepatol
2020[Nov]; 10
(6
): 533-539
PMID32837096
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AIM: Elevation of hepatic aminotransferases (aspartate aminotransferase
[AST]/alanine aminotransferase [ALT]) is commonly noted among COVID-19 patients.
It is unclear if they can predict the clinical outcomes among hospitalized
COVID-19 patients. We aim to assess if elevations in AST/ALT were associated with
poor outcomes in hospitalized COVID-19 patients. METHODS: We retrospectively
evaluated hospitalized COVID-19 patients with clinically significant elevated
aminotransferases (defined as >2 times upper limit of normal) and compared them
with COVID-19 patients without an elevation in aminotransferases. RESULTS: The
prevalence of elevation in AST/ALT was found to be 13.7% (20/145). The two groups
were similar in baseline demographics, comorbidities, and the majority of
laboratory tests. There was no difference in the mortality (50% vs. 36.8%, P =
0.32) and median hospital stay (7 days vs. 7 days, P = 0.78). However, there was
a statistically significant increase in the rates of mechanical ventilation among
elevated aminotransferases group compared with individuals without elevation (50%
vs. 24%, P = 0.028). However, this difference was not observed after adjusting
for inflammatory markers such as ferritin, lactate dehydrogenase, and lactic acid
levels. CONCLUSION: Elevated aminotransferases among hospitalized COVID-19
patients is associated with higher rates of mechanical ventilation but did not
achieve statistical significance after controlling for inflammatory markers.
Also, patients with elevated aminotransferases did not have higher rates of
mortality or prolonged length of stay.
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