Impact of COVID-19 infection on liver and alimentary tract: clinical insight

Aim of the study: Our aim was to evaluate the impact of COVID-19 infection on the liver and alimentary tract.

Material and methods: This is a retrospective multicenter study that was performed in non-intensive care units (ICU) at Minia, Assiut, and Sohag University Hospitals from March 1^st, 2020 to August 1^st, 2020. The clinical characteristics of 1238 consecutively confirmed COVID-19 discharged cases were enrolled. Patients with respiratory distress were recorded as severe cases, while others were recorded as mild-moderate cases. Patients with ≥ 2× upper limit of normal of alanine aminotransferase (ALT), aspartate aminotransferase (AST), or bilirubin were defined as patients with liver injury, while others were recorded as patients without liver injury.

Results: The severe group included 460 patients (37.2%) while the mild-moderate group included 778 patients (62.8%). Fever, white blood cell (WBC) and C-reactive protein (CRP) levels were significantly higher in the severe group (p < 0.05). The hepatic injury group included 296 patients (23.9%) while the group without hepatic injury included 942 patients (76.1%). Males were more likely to have liver injury (p < 0.05). Fever and abdominal pain were significantly higher in the hepatic injury group. Patients with liver injury had increased levels of WBCs, CRP and chest computed tomography (CT) score and had a longer hospital stay (p < 0.05). Chest CT score was a predictor of liver injury (p < 0.05).

Conclusions: Liver injury in non-ICU hospitalized COVID-19 patients is common but it is mild and has a good prognosis. Liver injury may be related to the degree of chest CT lesions.