Retrospective Cohort Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Aug 27, 2021; 13(8): 939-948
Published online Aug 27, 2021. doi: 10.4254/wjh.v13.i8.939
Hepatocellular injury and the mortality risk among patients with COVID-19: A retrospective cohort study
Ali Madian, Ahmed Eliwa, Hytham Abdalla, Haitham A Azeem Aly
Ali Madian, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Faculty of Medicine, Al-Azhar University-Assiut, Assiut 71524, Egypt
Ahmed Eliwa, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Faculty of Medicine, Al-Azhar University-Cairo, Cairo 11754, Egypt
Hytham Abdalla, Department of Chest Diseases, Faculty of Medicine, Al-Azhar University-Assiut, Assiut 71524, Egypt
Haitham A Azeem Aly, Department of Internal Medicine, Faculty of Medicine, Al-Azhar University-Assiut, Assiut 71524, Egypt
Author contributions: Madian A was responsible for study concept, design, acquisition, analysis, interpretation of data, statistical analysis and wrote draft of manuscript; Eliwa A and Abdalla H collected data; Aly HAA reviewed manuscript and provided critical scientific input; all authors approved of final manuscript draft.
Institutional review board statement: The study was approved by the ethics committee of Faculty of Medicine, Al-Azhar University, Assiut, Egypt.
Informed consent statement: No informed consent was required, as patient identity is not revealed in the retrospective analysis.
Conflict-of-interest statement: No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
Data sharing statement: The original anonymous dataset is available on request from the corresponding author at: a.madian@azhar.edu.eg.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ali Madian, MSc, MD, Lecturer, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Faculty of Medicine, Al-Azhar University-Assiut, Al Walideyah Al Bahreyah, Assiut 71524, Egypt. a.madian@azhar.edu.eg
Received: May 11, 2021
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
Processing time: 100 Days and 23.5 Hours
Core Tip

Core Tip: Liver injury with an aspartate aminotransferase (AST)-dominant pattern can predict the severity of coronavirus disease 2019 (COVID-19). A one-fold and two-fold increase in serum AST levels increased the odds of in-hospital mortality by eleven-fold and thirteen-fold, respectively, compared with individuals with normal AST levels. Our study confirmed an elevated level of ferritin in patients with COVID-19 that was associated with fatal outcomes. Meticulous monitoring is highly recommended for patients with COVID-19 presenting AST-dominant hepatocellular injury, especially those older than 60 years, those with elevated ferritin levels or those with diabetes mellitus.