COVID-19 impact on the liver

Table 1 Biochemical changes in patients with coronavirus disease 2019 and pre-existing chronic liver diseases in clinical trials

Ref.	Patients with COVID-19	Patients with abnormal liver function (%)	Patients with pre-existing liver diseases (%)
Guan et al[67]	1099	21.3 abnormal ALT; 22.2 abnormal AST	2.3
Huang et al[68]	41	31	2
Chen et al[39]	99	43	NA
Wang et al[69]	138	NA	2.9
Shi et al[70]	81	53.1	8.6
Xu et al[71]	62	16.1	11
Yang et al[72]	52	29	NA
Zhang et al[3]	56	28.6	3.6
Cai et al[25]	298	14.8 abnormal ALT; 8.7 abnormal AST	2.7
Cao et al[26]	128	43.8 abnormal ALT; 44.1 abnormal AST	NA
Zhang et al[73]	82	30.6 abnormal ALT; 61.1 abnormal AST; 30.6 abnormal TBIL	2.4
Fan et al[74]	148	21.6 abnormal AST; 18.2 abnormal ALT; 17.6 abnormal GGT; 6.1 abnormal TBIL	NA
Huang et al[75]	36	13.3 abnormal ALT; 58.1 abnormal AST; 12.9 abnormal TBIL	NA
Li et al[76]	85	24.7 abnormal ALT	7.05
Xie et al[77]	79	31.6 abnormal ALT; 35.4 abnormal AST; 5.1 abnormal TBIL	0
Zhang et al[78]	115	9.57 abnormal ALT; 4.78 abnormal AST	0
Zhao et al[79]	19	27.78 abnormal ALT; 44.4 abnormal AST; GGT	5.26
Sultan et al[32]	Meta-analysis of 47 studies 10890 patients	15.0 abnormal AST; 15.0 abnormal ALT; 16.7 abnormal TBIL	NA
Effenber et al[17]	96	42 abnormal AST	NA
Mantovani et al[80]	Meta-analysis of11 studies 2034 patients	NA	3
Hundt et al[81]	1827	Abnormal at admission (AST 66.9, ALT 41.6, ALP 13.5, and TBIL 4.3) and peak hospitalization (AST 83.4, ALT 61.6, ALP 22.7, and TBIL 16.1)	NA
Cai et al[24]	417	76.3 abnormal ALT, AST, TBIL and GGT	NA
Wang et al[8]	156	41.0 abnormal ALT and, AST	NA
Velarde-Ruiz Velasco et al[82]	99	35 abnormal AST; 28 abnormal ALT; 98 abnormal albumin	NA
Our unpublished data	849	38.39 abnormal ALT39.33 abnormal AST3.18 abnormal TBIL	3.65

COVID-19: Coronavirus disease 2019; ALT: alanine aminotransferase; AST: aspartate aminotransferase; GGT: gamma-glutamyl transferase; TBIL: Total bilirubin; NA: Not available.

Table 2 Demographic and clinical characteristics

	Total COVID-19 patients	Patients with abnormal liver function	Patients with pre-existing liver disease
Age (yr)
Minimum-maximum	0.083-97	0.33-97	32-88
Average	50.21	53.04 (P = 0.0215)	55.70 (P = 0.1351)
95%CI	48.85-51.58	51.09-54.99	51.08-60.33
Female (%)	54.18	52.31 (P = 0.5820)	48.38 (P = 0.6506)
Charlson score (%patients)
0	41.08	34.02 (P = 0.0190)	16.12 (P = 0.0094)
1-2	32.58	34.79 (P = 0.4664)	41.93 (P = 0.3592)
3-4	16.29	18.55 (P = 0.3585)	29.03 (P = 0.1049)
5-11	10.03	12.62 (P = 0.2034)	12.90 (P = 0.8281)
Number of days of hospitalization
Minimum-maximum	1-80	1-52	1-35
Average	11.06	11.53 (P = 0.3034)	11.35 (P = 0.8097)
95%CI	10.55-11.58	10.83-12.24	9.12-13.58
Curb 65 score (%)
0	12.43	10.34 (P = 0.3355)	10.00 (P = 0.8997)
1	62.18	59.41 (P = 0.3869)	63.33 (P = 0.9531)
2	23.11	26.52 (P = 0.2194)	23.33 (P = 0.8506)
3	3.51	3.71 (P = 0.9914)	3.33 (P = 0.6573)
Unfavourable evolution (death or transfer to intensive care) (%)	4.71	7.73 (P = 0.0454)	12.90 (P = 0.1126)

COVID-19: Coronavirus disease 2019; CI: Confidence interval.