Anas Habeeb Mohammed Matar Al-SharqiAl-Imamain Al-Kadhumein Medical City , Iraq
Title: Review of liver enzyme abnormalities in patients with SARS-CoV-2 infection
Background: Coronavirus disease (COVID-19) is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. The infection started to appear in Wuhan, China as an outbreak of pneumonia-like symptoms, and spread across the entire globe within a few weeks resulting in millions of morbidities and thousands of mortalities. While respiratory manifestations and consequences are well-defined and can be severe, GI manifestations of COVID-19 such as nausea, vomiting, diarrhea and abdominal pain are widely being recognized. Liver function derangements have been reported in COVID-19, but reported rates are variable. Treatment in intensive care units (ICU) has become a major challenge; therefore, early recognition of severe and critical cases is absolutely essential for timely triaging of patients.
Aim of the study: to review incidence of acute liver injury in patients with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2).
Patients and methods: obtaining clinical records and laboratory results prospectively from one hundred patients with PCR-confirmed or radiography-confirmed COVID-19, who are admitted to the isolation wards and emergency departments of three different hospitals in Baghdad from 1st of December 2020 to 31st of March 2021.
Results: The mean age group of the study sample was (61.2±12.36) years, males formed59%. GI manifestations were recorded in 47% of total cases, and were statistically correlated with disease severity (P value 0.001). Wide range of LFT abnormalities are found in patients with COVID-19, but none of which showed statistical significance in relation to disease severity. When LFT results were reviewed in relation to previous comorbidities, GGT was found to be statistically correlated with the underlying CLD (P value 0.001), and ALP with both underlying CLD and DM (P values <0.001 and 0.029, respectively) and even in the absence of underlying comorbidity (P value 0.006).
Conclusion: Liver enzyme derangements are increasingly reported in patients with COVID-19, but are not necessarily correlated with disease severity. Cholestatic picture of liver enzyme derangement is a more commonly recorded manifestation.
Anas Habeeb Mohammed Matar Al-Sharqi has completed his medical school at Kirkul University, Iraq at the age of 24. He started his journey as a junior doctor (what is named in some countries as foundation year doctor) in three different hospitals in Kirkuk city. Then, he became the chief physician at Kirkuk General Hospital for about a year before moving to Baghdad, the capital of Iraq, to start his specialization study in Internal Medicine at one of the greatest medical cities in the country. During COVID-19 pandemic, he was one of thousands of doctors who took part in this global war against the virus, and realized that making this study may benefit other doctors worldwide from the results achieved.