Serum Total Bilirubin and Aminotransferases in Patients with COVID-19 in Nellore District of South Andhra Pradesh

Abstract

BACKGROUND Corona virus disease - 19 (COVID -19) infection is an acute infectious disease caused by a newly discovered beta corona virus, severe acute respiratory syndrome corona virus 2 (SARS-CoV-2). While the primary target organ is the lungs, involvement of many other organs is often evident in patients with COVID - 19. There is emerging evidence to suggest association of SARS-CoV-2 infection with development of many liver abnormalities. The purpose of this study was to evaluate the prevalence of abnormal liver parameters in COVID - 19 patients and their variation in moderate and severe cases. METHODS This is a retrospective study. All patients with COVID -19, between the ages 20 - 75 years, encountered between April and May 2021, were included for the study and compared with age-matched controls. Severity of infection was defined based on the presence of symptoms, oxygen saturation, need for respiratory and intensive care support. Liver parameters such as serum total bilirubin (TBIL), serum aminotransferases, alanine aminotransaminase (ALT) and aspartate aminotransaminase (AST) were analysed. Inflammatory markers such as C-reactive protein (CRP) and D-dimer were also included for assay. RESULTS A total of 52 patients were encountered during the study period. Of these, 29 % (15/52) required intensive care. Abnormal liver parameters were observed in 14 (27 %) patients, and were significantly elevated compared to healthy controls. Liver dysfunction was markedly profound in severe infection than those with moderate disease. Higher levels of CRP and D-dimer were noted in severe patients of COVID - 19. CONCLUSIONS Mild liver abnormalities in the form of elevated ALT and AST are seen in COVID - 19 patients suggesting mild or no liver injury. These abnormal parameters do not generally lead to significant liver function impairment/failure and no specific treatment is required. KEY WORDS COVID - 19, Corona Virus, Liver Injury, Intensive Care Support.