Background: Abnormal liver chemistries are common findings in patients with COVID-19. It is unclear whether abnormal liver chemistries can predict the severity of COVID-19. Therefore, we compared the serum liver chemistries such as hepatic transaminases, total bilirubin, albumin, and prothrombin time to evaluate whether they can predict severity and mortality in COVID-19. Methods: An electronic search was performed on PubMed/Medline, EMBASE, and Google Scholar for studies comparing liver chemistries in severe and mild COVID-19. The literature search was performed using keywords “COVID-19,” “Liver,” Aspartate Aminotransferase (AST),” and “Alanine Aminotransferase (ALT),” “AST,” and “ALT,” in various combinations of “AND/OR” from December 1, 2019, till May 8, 2020. The pooled weighted mean difference (WMD) and 95% confidence interval (CI) were calculated for each component of liver chemistries. Results: Twenty-two studies were eligible, with 3,256 patients (54.57% males). Seventeen studies compared liver chemistries for severe vs. mild COVID-19, whereas five studies compared liver chemistries in survival vs. non-survival groups. The pooled WMD of AST and ALT in severe vs. mild COVID-19 were 12.23 (95% CI; 8.07, 16.39; p < 0.01) and 8.07 (95% CI 2.55, 11.91; p < 0.01), respectively. The pooled WMD for AST in survivors vs. non-survivors analysis was 8.82 ( n = 789; 95% CI; 2.27, 15.37; p < 0.01) and that of ALT was 4.70 ( n = 340; 95% CI 0.04,9.35; p = 0.05). Conclusion: Our meta-analysis shows that deranged liver chemistries may indicate severe COVID-19 and could also predict mortality. Larger studies are needed to evaluate the relationship between derangement in liver chemistries and mortality in COVID-19.
【저자키워드】 COVID-19, SARS-CoV-2, coronavirus, Liver tests, Liver chemistries, LFT, 【초록키워드】 Meta-analysis, Mortality, severe COVID-19, severity, serum, survival, severity of COVID-19, Patient, albumin, AST, Mild, liver, predict, ALT, Combination, Analysis, Prothrombin time, Google Scholar, total bilirubin, 95% CI, 95% confidence interval, mean difference, survivor, transaminases, FIVE, Aminotransferase, males, non-survivor, evaluate, was performed, calculated, groups, eligible, patients with COVID-19, 【제목키워드】 review, activity,