Assessment of abnormal liver function tests and associated factors among COVID-19-infected patients in Addis Ababa, Ethiopia, 2022: a facility-based comparative cross-sectional study

BMJ Open. 2024 Sep 10;14(9):e076647. doi: 10.1136/bmjopen-2023-076647.

Abstract

Objective: Liver function test (LFT) abnormalities are higher in patients with severe COVID-19. Most of the studies on this theme were conducted in foreign nations, and the association with LFT abnormalities was not sufficiently addressed in the study areas. Therefore, the current study aimed to investigate the effects of COVID-19 infection on liver function of patients.

Setting: A facility-based comparative cross-sectional study was carried out from 10 April to 15 June 2022, among COVID-19 infected individuals admitted in Eka Kotebe General Hospital and Saint Petrous Specialized Hospitals, Addis Ababa, 2022.

Participants: A total of 284 confirmed COVID-19-positive and COVID-19-negative controls matched by gender and age were included in the present study.

Results: Among SARS-COV-2 positive groups, 63 (44.4%) had one or more LFT abnormalities. The most common elevated level of the LFTs among patients with COVID-19 were gamma-glutamyl transferase (GGT) 50 (35.2%), while the most common lowered level was albumin 58 (40.8%). The mean values of aspartate aminotransferase (AST) (35.4±26.9 vs 22.9±12.6, p<0.001) were significantly different between patients with COVID-19 and the COVID-19-free groups. Being COVID-19-positive was significantly associated with an elevated level of AST (AOR=3.0, 95% CI 1.2 to 7.4) and GGT (AOR=4.55, 95% CI 2.02 to 10.3). Being male was significantly associated with an elevated level of total bilirubin (BILT, AOR=2.41, 95% CI 1.2 to 4.9) and direct bilirubin (BILD, AOR=3.7, 95% CI 1.72 to 8.2), and also severe stage of COVID-19 was associated with hypoalbuminaemia (AOR=3.3, 95% CI 1.4 to 7.9). SARS-COV-2 infection was independently associated with LFT abnormality.

Conclusion: Patients with COVID-19 had decreased albumin levels, and elevated AST, GGT, BILT and BILD levels.

Keywords: COVID-19; biochemistry; hepatology.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aspartate Aminotransferases / blood
  • COVID-19* / blood
  • COVID-19* / complications
  • COVID-19* / diagnosis
  • COVID-19* / epidemiology
  • COVID-19* / physiopathology
  • Cross-Sectional Studies
  • Ethiopia / epidemiology
  • Female
  • Humans
  • Liver Diseases / blood
  • Liver Diseases / epidemiology
  • Liver Function Tests* / methods
  • Male
  • Middle Aged
  • SARS-CoV-2*
  • gamma-Glutamyltransferase / blood

Substances

  • Aspartate Aminotransferases
  • gamma-Glutamyltransferase