Evaluation of serum hepatic enzyme activities in different COVID‐19 phenotypes

Abstract

Coronavirus disease 2019 (COVID‐19) is a newly emerging infectious disease. Our understanding of the clinical characteristics of liver damage and the relationship with disease severity in COVID‐19 is still limited. To investigate the serum hepatic enzyme activities in different phenotypes of COVID‐19 patients, evaluate their relationship with the illness severity and analyze the correlation of glycyrrhizin treatment and abnormal liver enzyme activities, one hundred and forty‐seven patients with COVID‐19 were enrolled in a retrospective study that investigated hepatic dysfunction. Liver alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactic dehydrogenase (LDH), Y‐glutamyl transferase (GGT), superoxide dismutase (SOD), and alkaline phosphatase (ALP) were analyzed in these patients. Patients with diammonium glycyrrhizinate (DG) treatment were further investigated. Of the 147 patients, 56 (38.1%) had abnormal ALT activity and 80 (54.4%) had abnormal AST activity. The peak of abnormal hepatic enzyme activities occurred at 3 to 6 days after on admission. Serum AST and LDH levels were elevated, while the SOD level was decreased in severe and critical patients, compared with mild cases. DG treatment may alleviate the abnormal liver enzyme activities in non‐critical COVID‐19 patients. Abnormal liver functions may be observed in patients with COVID‐19, and were associated with SARS‐CoV‐2‐induced acute liver damage. Glycyrrhizin treatment may be an effective therapeutic approach for the outcome of abnormal hepatic enzyme activities in severe COVID‐19 cases. Serum hepatic enzyme tests may reflect the illness severity and should be monitored.

Routine Laboratory Parameters as a Tool for Predicting Death in Patients With COVID-19

“…Additionally, the extent of bilirubin in non-survivors had shown significantly increased levels. In similar studies, an increase in total bilirubin has been reported in patients with severe COVID-19 [31,32]. In our study, the amount of albumin has decreased in the non-survivors, which was similar to the results of an investigation by Huang et al, who reported that serum albumin level <35 g/L at presentation increased the risk of death in COVID-19 by at least 6-fold [28].…”

“…The liver impairment in COVID-19 is not a prominent feature; however, the mechanism and importance of elevated ALP and total Bilirubin must be considered in the association of prognosis. Accordingly, numerous cases of changes in liver enzymes have been reported in patients with COVID-19, including increased ALT, AST, LDH, Y-Gammaglutamyl Transferase (GGT), Superoxide Dismutase (SOD), ALP, and total Bilirubin [31,32]. We found that ALP levels were higher in nonsurvivor.…”

Patients with COVID-19 and HBV Coinfection are at Risk of Poor Prognosis

“…Previous studies have shown that coinfection with HBV and other viruses can lead to rapid progression of liver disease and an increased risk of death [ 7 ]. In addition, COVID-19 also causes abnormal liver function and liver damage [ 8 ]. However, the results of previous studies are inconsistent on whether COVID-19 and HBV coinfection will increase the risk of death and critical illness [ 6 , 9 ].…”

Jeopardy of COVID-19: Rechecking the Perks of Phytotherapeutic Interventions

“…Patients had also increased serum LDH levels and decreased SOD levels. However, treatment with diammonium glycyrrhizinate preparation alleviated the abnormal liver enzyme activities in non-critical COVID-19 patients [189]. It's another preparation Diammonium glycyrrhizinate has shown to reduce acute liver injury in patients with COVID-19 [190].…”