Coronavirus Disease 2019 Associated Liver Injury and Disease Severity: A Cross-Sectional Study

Abstract

Recent data on the coronavirus disease 2019 (Covid-19) outbreak has begun to shine light on the impact of the disease on the liver. However, data regarding Covid-19-associated liver injury remains limited. We analyzed whether there was a significant difference in liver injury in patients with different disease severity. A cross-sectional study was conducted for confirmed Covid-19 cases in dr. Cipto Mangunkusumo National Hospital from April 2020 until March 2021. Patients were divided based on disease severity: mild-to-moderate and severe Covid-19. Patients with existing chronic hepatitis, liver cirrhosis, fatty liver, or liver malignancies were excluded. Data on liver transaminase, prothrombin time, albumin, and bilirubin levels upon admission were analyzed for both groups. A total of 100 patients were included, consisting of 50 patients with mild-to-moderate cases and 50 patients with severe cases. Both alanine and aspartate aminotransferase levels elevation were predominantly found in the severe group (p<0.001 and p=0.002, respectively). We also found lower albumin levels in the severe group (p<0.001), but no significant difference in bilirubin level (p=0.568) and prothrombin time (p=0.253) was noted among the two groups. Liver injury is more common in severe than mild-to-moderate Covid-19 cases. This should be a consideration by physicians to handle the patients comprehensively.