https://doi.org/10.5812/jjm-153763

Investigation of Liver Function Test Findings in COVID-19 Patients Considering the Timeline of Disease

authors:

avatar Mohsen Nakhaie ORCID 1 , avatar Javad Charostad ORCID 2 , avatar Emad Behboudi 3 , avatar Yaser Ghelmani 4 , avatar Samaneh Jahangiri 5 , avatar Nadieh Baniasadi 6 , avatar Arman Khajouei 7 , avatar Mohammad Reza Zangouey 8 , avatar Faranak Salajegheh 7 , *

Gastroenterology and Hepatology Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
Department of Microbiology, Faculty of Medicine, Shahid-Sadoughi University of Medical Sciences, Yazd, Iran
Department of Basic Medical Sciences, Khoy University of Medical Sciences, Khoy, Iran
Faculty of Internal Medicine, Shahid-Sadoughi University of Medical Sciences, Yazd, Iran
Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
Noncommunicable Diseases Research Center, Bam University of Medical Sciences, Bam, Iran
Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
Department of Medical Immunology, Afzalipour Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
Jundishapur Journal of Microbiology: Vol.17, issue 11; e153763
article type: Research Article
revised: November 18, 2024

How To Cite Nakhaie M, Charostad J, Behboudi E, Ghelmani Y, Jahangiri S, et al. Investigation of Liver Function Test Findings in COVID-19 Patients Considering the Timeline of Disease. Jundishapur J Microbiol. 2024;17(11):e153763. https://doi.org/10.5812/jjm-153763.

Abstract

Background: Several lines of evidence represent the impact of SARS-CoV-2 infection on liver functions; however, the evaluation of these phenomena as a trend according to the disease timeline still remains vague. The study objective was to identify possible alterations in liver function parameters during the first to fifth waves of COVID-19 and compare them with the demographic and clinical outcomes of patients among the waves. 
Methods: This cross-sectional study included 1501 hospitalized patients with a confirmed RT-PCR diagnosis of COVID-19 referred to Shahid Sadoughi Hospital, Yazd, Iran, between November 20, 2019, and November 20, 2021. Liver function parameters, including alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), total bilirubin, direct bilirubin, and albumin, were assessed using standard clinical laboratory methods. Statistical analyses were conducted to evaluate differences in liver function parameters across the five pandemic waves, with significance set at P < 0.05.
Results: The median age of the hospitalized patients (N=1501) was 61±21.8 years, with the majority being males (816, 54.3%). The Kruskal-Wallis test showed a significant increase in the median levels of ALP, total bilirubin, and direct bilirubin in the first wave, AST and ALT in the third wave, and serum albumin in the second wave (P<0.001). The median serum levels of total bilirubin and direct bilirubin were significantly increased in older patients compared to younger patients (P<0.001), and the median ALT and serum albumin were significantly decreased in older patients (P<0.0001). In males, the median values of AST, ALT, total bilirubin, and direct bilirubin were significantly higher than in females (P<0.0001). The median values of all parameters except serum albumin in deceased patients were significantly higher compared to discharged patients, and serum albumin was significantly decreased.
Conclusion: In this descriptive study, we observed that older and male patients were more hospitalized than females. Our findings showed differences in liver parameters between pandemic waves, suggesting different behaviors of different SARS-CoV-2 strains.