Karn Wijarnpreecha1, Patompong Ungprasert2, Panadeekarn Panjawatanan3, Denise M Harnois1, Himesh B Zaver4, Aijaz Ahmed5, Donghee Kim5. 1. Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Jacksonville, Florida. 2. Department of Rheumatic and Immunologic Diseases, Cleveland Clinic, Cleveland, Ohio. 3. Department of Internal Medicine, Bassett Medical Center, Cooperstown, New York. 4. Department of Internal Medicine, Mayo Clinic, Jacksonville, Florida. 5. Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Department of Medicine, Stanford, California, USA.
Abstract
BACKGROUND/AIMS: The number of cases with coronavirus disease 2019 (COVID-19) has exceeded seven million worldwide. However, the data describing the global prevalence of liver injury associated with COVID-19 is lacking secondary to the novelty of this ongoing pandemic. Therefore, we conducted a meta-analysis to determine the association between COVID-19 and liver injury. METHODS: A systematic literature search of indexed databases including, PubMed, Medline, and Embase databases from inception to 14 April 2020, was used to identify studies that reported data of liver chemistry in patients diagnosed with COVID 19. The overall prevalence of abnormal liver chemistry and relevant 95% confidence interval was used to estimate the pooled results studies. RESULTS: Sixty-four studies with 11 245 patients with COVID-19 were included. The pattern of abnormal liver enzymes was notable for higher aspartate aminotransferase (AST) than alanine aminotransferase (ALT) levels. The overall global prevalence of elevated AST, ALT, total bilirubin, gamma-glutamyltransferase (GGT), and alkaline phosphatase was 23.2, 21.2, 9.7, 15.0, and 4.0%, respectively. The prevalence of elevated AST was substantially higher among those with severe cases (45.5%) compared to non-severe cases (15.0%). Co-existing chronic liver disease presented up to 37.6% of patients with COVID-19. CONCLUSION: A fourth of COVID-19 patients had elevated liver enzymes and associated with disease severity. Our study may be used as a guide for clinicians and epidemiologists to proactively identify other sources of injury and illness in patients diagnosed with COVID-19. Intensive monitoring for liver injury may be needed in cases with severe COVID-19.
BACKGROUND/AIMS: The number of cases with coronavirus disease 2019 (COVID-19) has exceeded seven million worldwide. However, the data describing the global prevalence of liver injury associated with COVID-19 is lacking secondary to the novelty of this ongoing pandemic. Therefore, we conducted a meta-analysis to determine the association between COVID-19 and liver injury. METHODS: A systematic literature search of indexed databases including, PubMed, Medline, and Embase databases from inception to 14 April 2020, was used to identify studies that reported data of liver chemistry in patients diagnosed with COVID 19. The overall prevalence of abnormal liver chemistry and relevant 95% confidence interval was used to estimate the pooled results studies. RESULTS: Sixty-four studies with 11 245 patients with COVID-19 were included. The pattern of abnormal liver enzymes was notable for higher aspartate aminotransferase (AST) than alanine aminotransferase (ALT) levels. The overall global prevalence of elevated AST, ALT, total bilirubin, gamma-glutamyltransferase (GGT), and alkaline phosphatase was 23.2, 21.2, 9.7, 15.0, and 4.0%, respectively. The prevalence of elevated AST was substantially higher among those with severe cases (45.5%) compared to non-severe cases (15.0%). Co-existing chronic liver disease presented up to 37.6% of patients with COVID-19. CONCLUSION: A fourth of COVID-19patients had elevated liver enzymes and associated with disease severity. Our study may be used as a guide for clinicians and epidemiologists to proactively identify other sources of injury and illness in patients diagnosed with COVID-19. Intensive monitoring for liver injury may be needed in cases with severe COVID-19.
Authors: Matteo Briguglio; Tiziano Crespi; Fabio Pino; Marco Mazzocchi; Mauro Porta; Elena De Vecchi; Giuseppe Banfi; Paolo Perazzo Journal: Front Med (Lausanne) Date: 2021-03-25
Authors: Abraham Edgar Gracia-Ramos; Joel Omar Jaquez-Quintana; Raúl Contreras-Omaña; Moises Auron Journal: World J Gastroenterol Date: 2021-07-14 Impact factor: 5.742