Assessment of Liver Function and Its Correlation with Inflammatory Markers and Severity of Disease during COVID-19 Second Wave in a Tertiary Care Centre
Arun Dhotra *
Department of Digestive Health and Diseases, Government Kilpauk Medical College, Chennai, India.
A. Anand
Department of Digestive Health and Diseases, Government Kilpauk Medical College, Chennai, India.
Kani Shaikh
Department of Digestive Health and Diseases, Government Kilpauk Medical College, Chennai, India.
A. R. Akilandeshwari
Department of Digestive Health and Diseases, Government Kilpauk Medical College, Chennai, India.
N. Arun
Department of Digestive Health and Diseases, Government Kilpauk Medical College, Chennai, India.
*Author to whom correspondence should be addressed.
Abstract
Aims: To assess the Liver function in COVID-19 infection and study its correlation with inflammatory markers and severity of disease.
Study Design: A Retrospective Observational study.
Place and Duration of Study: Government Kilpauk Medical College, Chennai, India. Two month study period was taken during the second COVID wave (1st May 2021 to 30th June 2021).
Methodology: The study covered all COVID-19 positive individuals who were over the age of 19. Patients with any chronic liver disease, Hepatitis B or Hepatitis C were excluded. Data was collected from case files. Record was made of the liver function tests and inflammatory markers – C-Reactive Protein and Interleukin-6 (CRP, IL-6). Severe disease was defined as patients with respiratory rate > 30/min, SpO2 <90% on room air or requiring Intensive Care Unit (ICU) admission or mechanical ventilation. Collected data was analysed using appropriate statistical tests.
Results: 132 patients were included in the study. Out of these 59 patients (44.70%) had elevated Liver function tests (LFTs). Maximum patients (42.37%) had hepatocellular pattern. 59.32% patients were males. Mean age of patients with elevated LFTs was 51.03±13.03 years. ICU admission was required in 40.68% of patients with deranged LFTs compared to 23.28% in patients with normal LFTs, which was statistically significant (P <0.03). A positive correlation was found between deranged LFTs and inflammatory markers (CRP, IL-6). (P <0.001).
Conclusion: A significant number of COVID-19 positive individuals have abnormal liver function. Inflammatory indicators and elevated LFTs have a positive relationship. Patients with abnormal liver function tests were more likely to have severe illness.
Keywords: COVID-19, liver function test, severe disease, inflammatory markers