Published online Dec 27, 2021. doi: 10.4254/wjh.v13.i12.2005
Peer-review started: April 22, 2021
First decision: June 15, 2021
Revised: July 2, 2021
Accepted: November 18, 2021
Article in press: November 18, 2021
Published online: December 27, 2021
Core Tip: Looking at the liver tests in patients with severe coronavirus disease 2019 (COVID-19), C-reactive protein (CRP) showed a strong correlation with the aspartate aminotransferase (AST) levels. This was observed in both intensive care units (ICU) and non-ICU patients. However, CRP levels were higher in non-ICU patients with liver damage, whereas alanine aminotransferase (ALT) was higher in ICU COVID-19 patients. Thus, like interleukin-6 (IL-6), ferritin, and CRP correlated directly with AST and ALT levels in non-ICU patients, there is a direct correlation of IL-6 and acute phase proteins with AST in severe COVID-19 cases. These observations confirm the critical impact of systemic inflammation and specifically elevated IL-6 during severe acute respiratory coronavirus 2 cytokine storm on liver injury.