COVID-19 and liver dysfunction: A systematic review and meta-analysis of retrospective studies

J Med Virol. 2020 Oct;92(10):1825-1833. doi: 10.1002/jmv.26055. Epub 2020 Jul 27.

Abstract

Recently, Coronavirus Disease 2019 (COVID-19) pandemic is the most significant global health crisis. In this study, we conducted a meta-analysis to find the association between liver injuries and the severity of COVID-19 disease. Online databases, including PubMed, Web of Science, Scopus, and Science direct, were searched to detect relevant publications up to 16 April 2020. Depending on the heterogeneity between studies, a fixed- or random-effects model was applied to pool data. Publication bias Egger's test was also performed. Meta-analysis of 20 retrospective studies (3428 patients), identified that patients with a severe manifestation of COVID-19 exhibited significantly higher levels of alanine aminotransferase, aspartate aminotransferase, and bilirubin values with prolonged prothrombin time. Furthermore, lower albumin level was associated with a severe presentation of COVID-19. Liver dysfunction was associated with a severe outcome of COVID-19 disease. Close monitoring of the occurrence of liver dysfunction is beneficial in early warning of unfavorable outcomes.

Keywords: COVID-19; SARS-CoV-2; liver function; meta-analysis; outcome.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Alanine Transaminase / blood
  • Aspartate Aminotransferases / blood
  • Bilirubin / blood
  • COVID-19 / complications*
  • Humans
  • Liver / physiopathology
  • Liver Diseases / virology*
  • Prothrombin Time

Substances

  • Aspartate Aminotransferases
  • Alanine Transaminase
  • Bilirubin