Abnormal liver function in COVID-19 tied to longer hospital stay

Patients with coronavirus disease 2019 (COVID-19) may present with abnormal liver function, which in turn is associated with longer hospital stay, a study reports.

Researchers looked at 148 consecutive patients (mean age, 50 years; 50.68 percent male) admitted at the Shanghai Public Health Clinical Center from January 20 through 31, evaluating patient outcomes until February 19. Abnormal liver function was defined as elevation in concentrations of alanine and aspartate aminotransferase, gamma glutamyltransferase, alkaline phosphatase, and total bilirubin.

Fifty-five COVID-19 patients presented with abnormal liver function at hospital admission. Most of these patients were men and had higher levels of procalcitonin and C-reactive protein.

Significantly more patients in the abnormal liver function group had high fever than in the group with normal liver function (14.5 percent vs 4.3 percent; p=0.027). There was no between-group difference in medications taken before hospitalization, although a markedly higher proportion of patients in the former group had received lopinavir/ritonavir after admission (57.8 percent vs 31.3 percent).

Mean hospital stay was significantly longer in the group of patients with abnormal liver function than in those with normal liver function (15.09 vs 12.76 days; p=0.021).

The researchers explained that SARS-CoV-2, the causative agent for COVID-19, potentially causes liver function damage and that liver injury following admission may be associated with the use of lopinavir/ritonavir. These data may guide clinical treatment of patients during the current pandemic.