Published online Feb 27, 2022. doi: 10.4254/wjh.v14.i2.479
Peer-review started: September 15, 2021
First decision: October 18, 2021
Revised: October 22, 2021
Accepted: February 10, 2022
Article in press: February 10, 2022
Published online: February 27, 2022
Processing time: 159 Days and 21.3 Hours
Since the coronavirus disease 2019 (COVID-19) has hit the world as a pandemic, researchers all over the world have worked on its diagnostics, prognosticating factors, etc. The present study showed liver enzymes, especially aspartate aminotransferase (AST) levels, to be high in non-survivors with raised AST/alanine aminotransferase ratio. Considering the non-specific nature of AST with its presence in organs other than liver such as muscle, heart, kidney and brain makes it difficult to interpret. Even pre-existing metabolic syndrome and non-alcoholic fatty liver disease are confounding factors for deranged liver functions detected during COVID-19 disease. Therefore, the results of the study should be taken with caution.
Core Tip: The presence of angiotensin converting enzyme 2 receptors in liver endothelial cells makes it susceptible to severe acute respiratory syndrome coronavirus 2 injury. The authors have suggested raised aspartate aminotransferase (AST) levels in almost a third of non-survivors along with high AST/alanine aminotransferase ratio. Considering the presence of AST in organs other than liver such as muscle, red blood cells, heart and kidney, makes the interpretation difficult. Additionally, pre-existing non-alcoholic fatty liver disease has also been documented as a risk factor for severe coronavirus disease 2019 (COVID-19) disease. Therefore, more studies are needed for evaluation of AST as a predictive factor for severe COVID-19 disease.