COVID-19 is associated with a high prevalence of liver damage: a systematic review and meta-analysis

Authors

DOI:

https://doi.org/10.3126/jpahs.v8i3.32233

Keywords:

Coronavirus, COVID-19, Liver Injury, Liver Disease, SARS-CoV-2, Liver Function Test

Abstract

Introduction: The Coronavirus Disease 2019 (COVID-19) outbreak is a serious threat to humans, and the impact of COVID-19 on the liver remains unexplored. At present, no meta-analysis has summarized available findings of COVID-19 patients with liver injury in depth. Thus, we aimed to scrutinize the association of the liver in COVID-19 patients and approximate the prognosis of COVID-19 patients with liver injury thoroughly.

Method: We searched different databases for qualified studies between December 2019 to May 2021. Finally, meta-analysis was carried out using fixed-effect or random-effect models based on the heterogeneity.

Result: Our Meta-analysis includes 32 studies with a total of 6,933 COVID-19 patients. The pooled prevalence of chronic liver disease (CLD) was 3.5%. Overall, the rates of severity and mortality in COVID-19 patients with underlying CLD were 4.6% and 19.2%, respectively. Additionally, the incidence of acute on chronic failure (ACLF) among COVID-19 patients with CLD was 25.1%. The prevalence of an increase in serum ALT, AST, TBil, and LDH levels was 39.5%, 28.6%, 26.5%, and 55.5%, respectively. Similarly, PT was prolonged in 8.3% of cases, and albumin was decreased in 66.8% of cases. The pooled prevalence of liver injury among COVID-19 patients was 28.2%. Strikingly, the patients with liver injury had significantly more severe disease (42.3%) and a higher incidence of mortality (18.5%) than the patients without liver injury.

Conclusion: In conclusion, more than one in five of the COVID-19 patients is at risk of developing a liver injury. Further, patients with liver injury have significantly more severe disease and a higher incidence of mortality than patients without liver injury. Thus, careful monitoring of liver function is advisable while treating COVID-19 patients.

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Author Biographies

Dipesh Yadav, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China

Postdoctoral Researcher, Department of Hepatobiliary Surgery & Liver Transplantation

Alina Singh, Pokhara Medical Clinic, Pokhara, Nepal

Medical Officer, Department of Surgery

Akanand Singh, Chitwan Medical College, Tribhuvan University, Bharatpur, Nepal

Postdoctoral Researcher, Department of Surgery

Rajesh Kumar Yadav, Gandaki Medical College Teaching Hospital and Research Centre, Pokhara, Nepal

Associate Professor, Department of Pharmacology

Bai Xue Li, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China

Professor, Department of Hepatobiliary Surgery & Liver Transplantation

Liang Tingbo, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China

Professor, Department of Hepatobiliary Surgery & Liver Transplantation

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Published

2021-12-31

How to Cite

Yadav, D., Singh, A., Singh, A., Yadav, R. K., Li, B. X., & Tingbo, L. (2021). COVID-19 is associated with a high prevalence of liver damage: a systematic review and meta-analysis. Journal of Patan Academy of Health Sciences, 8(3), 38–51. https://doi.org/10.3126/jpahs.v8i3.32233

Issue

Section

COVID-19: Review Articles