Saudi Journal of Gastroenterology
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ORIGINAL ARTICLE
Year : 2020  |  Volume : 26  |  Issue : 5  |  Page : 272-278

Abnormal liver-related biomarkers in COVID-19 patients and the role of prealbumin


1 Medical Team Backing Hubei Province; Departments of Infectious Disease and Hepatolgy, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
2 Intensive Care Unit, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
3 Medical Team Backing Hubei Province; Endocrinology, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
4 Medical Team Backing Hubei Province; Rehabilitation Medicine, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
5 Medical Team Backing Hubei Province; Cardiology, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
6 Departments of Infectious Disease and Hepatolgy, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China

Correspondence Address:
Dr. Fengtao Wei
Department of Cardiology, The Second Hospital, Cheeloo College of Medicine, Shandong University, 247 Beiyuan Road, Jinan
China
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/sjg.SJG_239_20

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Background/Aims: We aimed to evaluate the distribution of abnormal liver-related biomarkers in patients with coronavirus disease (COVID-19) and explore the prognostic value of elevated liver enzymes and abnormal liver synthetic capacity with regards to patient mortality. Patients and Methods: This retrospective observational study included 80 laboratory-confirmed COVID-19 cases. Data were collected from the electronic medical record system by a trained team of physicians. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TB), albumin, and prealbumin levels at admission and on day 7 after admission were collected. The primary outcome of the current study was patient mortality. Results: Abnormal ALT, AST, TB, albumin, and prealbumin levels were observed in 11 (13.8%), 15 (18.8%), 5 (6.3%), 22 (27.5%), and 31 (38.8%) patients, respectively. Male gender correlated with elevated ALT and AST levels (p = 0.027 and 0.036, respectively). Higher levels of AST and lower levels of albumin and prealbumin were associated with patient mortality (p = 0.009, 0.002, and 0.003, respectively). Multivariate Cox regression analysis identified patient age (p = 0.013, HR 1.108) and prealbumin levels (p = 0.015, HR 0.986) as independent predictors for patient mortality. However, changes in liver-related biomarkers were not associated with poor outcome in multivariate analysis (p > 0.05). Conclusions: Abnormalities in albumin and prealbumin levels are common among COVID-19 patients and hypoprealbuminemia independently predicts adverse outcome and should be carefully considered in clinical practice. Moreover, changes in liver-related biomarkers is not a salient feature of COVID-19.


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