Abnormal Liver Function Test in Patients Infected with Coronavirus (SARS-CoV-2): A Retrospective Single-Center Study from Spain

Abstract
The outbreak of the novel coronavirus SARS-CoV-2 epidemic has rapidly spread and still poses a serious threat to healthcare systems worldwide. In the present study, electronic medical records containing clinical indicators related to liver injury in 799 COVID-19-confirmed patients admitted to a hospital in Madrid (Spain) were extracted and analyzed. Correlation between liver injury and disease outcome was also evaluated. Serum levels of Alanine aminotransferase (ALT), Aspartate aminotransferase (AST), Gamma-glutamyltransferase (GGT), Alkaline phosphatase (ALP), Lactate dehydrogenase (LDH) and AST/ALT ratio were elevated above the Upper Limit of Normal (ULN) in 25.73%, 49.17%, 34.62%, 24.21%, 55.84% and 75% of patients, respectively. Interestingly, significant positive correlation between LDH levels and the AST/ALT ratio with disease outcome was found. Our data showed that SARS-CoV-2 virus infection leads to mild, but significant changes in serum markers of liver injury. The upregulated LDH levels as well as AST/ALT ratios upon admission may be used as additional diagnostic characteristic for COVID-19 patients.
Funding Information
  • Instituto de Salud Carlos III (PI16/01126)
  • Departamento de Salud, Gobierno de Navarra (58/17)
  • Ministerio de Economía y Competitividad (SAF2014-54708-R, SAF2016-78711, SAF2017-87919-R, RYC-2014-15242, RYC-2015-17438)
  • Dirección General de Universidades e Investigación (S2017/BMD-3727, Y2018/NMT-4949)
  • ERAB: The European Foundation for Alcohol Research (18/14)
  • AMMF Foundation (2018/117)
  • Universidad Complutense de Madrid (25/2019, CT82/20-CT83/20)
  • European Cooperation in Science and Technology (CA17112)
  • Deutsche Forschungsgemeinschaft ((SFB/TRR57/P04, SFB 1382-403224013/A02 and DFG NE 2128/2-1))
  • Gilead Sciences (Liver Scholar Award)