Published online Aug 27, 2021. doi: 10.4254/wjh.v13.i8.939
Peer-review started: May 11, 2021
First decision: June 23, 2021
Revised: July 7, 2021
Accepted: July 14, 2021
Article in press: July 14, 2021
Published online: August 27, 2021
Clearly, infection with severe acute respiratory syndrome coronavirus 2 is not limited to the lung but also affects other organs.
Predictive models are needed to determine patients’ prognoses and to improve health care resource allocation during the coronavirus disease 2019 (COVID-19) pandemic.
To investigate whether biomarkers of hepatocellular injury at admission have prognostic value in predicting all-cause in-hospital mortality in patients with COVID-19.
A retrospective cohort study was conducted on 376 consecutive adult patients admitted to Al-Azhar University Hospital, Assiut, Egypt and Abo Teeg General Hospital, Assiut, Egypt with confirmed COVID-19 from June 1, 2020 to July 30, 2020.
High-risk populations, especially patients aged ≥ 60 years, patients with aspartate aminotransferase (AST)-dominant liver injury or those with diabetes, should be intensively monitored. Admission serum AST and serum ferritin levels have the strongest association with the prognosis of patients with COVID-19 and can be used to monitor patients with COVID-19 at risk of liver injury.
Liver injury with an AST-dominant pattern can predict the severity of COVID-19. This study confirmed an elevated level of ferritin in patients with COVID-19. Elevated serum ferritin levels are associated with in-hospital mortality.
Meticulous monitoring is highly recommended for patients with COVID-19 presenting AST-dominant hepatocellular injury, especially those older than 60 years, patients with elevated serum ferritin levels or those with diabetes mellitus.