Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

Abnormal Liver Biochemistry Tests and Acute Liver Injury in COVID-19 Patients: Current Evidence and Potential Pathogenesis

Version 1 : Received: 23 May 2021 / Approved: 24 May 2021 / Online: 24 May 2021 (10:14:53 CEST)

A peer-reviewed article of this Preprint also exists.

McGrowder, D.A.; Miller, F.; Anderson Cross, M.; Anderson-Jackson, L.; Bryan, S.; Dilworth, L. Abnormal Liver Biochemistry Tests and Acute Liver Injury in COVID-19 Patients: Current Evidence and Potential Pathogenesis. Diseases 2021, 9, 50. McGrowder, D.A.; Miller, F.; Anderson Cross, M.; Anderson-Jackson, L.; Bryan, S.; Dilworth, L. Abnormal Liver Biochemistry Tests and Acute Liver Injury in COVID-19 Patients: Current Evidence and Potential Pathogenesis. Diseases 2021, 9, 50.

Journal reference: Diseases 2021, 9, 50
DOI: 10.3390/diseases9030050

Abstract

Globally, over the past several months millions of persons contracted the coronavirus disease 2019 (COVID-19) resulting in significant mortality. Health care systems are negatively impacted including the care of individuals with cancers and other chronic diseases such as chronic active hepatitis, cirrhosis and hepatocellular carcinoma. There are various probable pathogenic mechanisms that have been presented to account for liver injury in COVID-19 patients such as hepatotoxicity cause by therapeutic drugs, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection of the bile duct cells and hepatocytes, hypoxia and systemic inflammatory response. Liver biochemistry tests such as AST, ALT, GGT and ALP are deranged in COVID-19 patients with liver injury. Hepatocellular damage results in the elevation of serum AST and ALT levels in early onset disease while a cholestatic pattern that develops as the disease progress causes higher levels of ALP, GGT, direct and total bilirubin. These liver biochemistry tests are prognostic markers of disease severity and should be carefully monitored in COVID-19 patients. We conducted a systematic review of abnormal liver biochemistry tests in COVID-19 and the possible pathogenesis involved. Significant findings regarding the severity, hepatocellular pattern, incidence and related clinical outcomes in COVID-19 patients are highlighted.

Keywords

Liver; biochemistry tests; function; COVID-19; injury; SARS-CoV-2; infection; severity; mortality

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