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?:abstract
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Aim: The current study aimed to report a pooled analysis of the association of the circulating levels of liver enzymes and total bilirubin with severe and non-severe COVID-19 Background: The ongoing coronavirus outbreak is an important threat to health worldwide Epidemiological data representing greater risk of liver failure in patients infected with Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) Methods: Electronic databases were comprehensively searched using Medline, ISI Web of Science, EMBASE, and the Cochrane Library up to July 2020 Outcomes from each relevant study were pooled using a random-effects model Heterogeneity was analyzed by Q test and I2 statistics Sensitivity analysis was also evaluated Results: A total of 24 studies were included (4,246 patients) in this study We found a significant association of COVID-19 severity with increased levels of ALT [SMD: 1 40 U/L;95% CI (0 93, 1 88);P <0 05, I2 = 96 5%, PHeterogenity = 0 000 ], AST [SMD: 2 11 U/L;95% CI (1 40, 2 83);P <0 05, I2 = 97 9%, PHeterogenity = 0 000], LDH [SMD: 3 88 U/L;95% CI (2 70, 5);P <0 05, I2 = 98 7%, PHeterogenity = 0 000] and TBil [SMD: 1 08 μmol/L;95% CI (0 44, 1 72);P = 0 001, I2 = 97 7, PHeterogenity = 0 000], whereas, ALP values [SMD: 0 31;95% CI (-1 57, 2 20);P = 0 74] was not significant between severe and non-severe COVID-19 patients Moreover, elevated liver enzymes were found more in males [OR: 1 52, (95% CI 1 26, 1 83), P <0 05] with severe COVID-19 infection than in females Conclusion: The alterations of liver function indexes caused by SARS-CoV-2 infection suggested a potential prognosis biomarker for screening of severe patients at early stages of the disease © 2020 RIGLD, Research Institute for Gastroenterology and Liver Diseases
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