Int J Med Sci 2021; 18(1):176-186. doi:10.7150/ijms.50691 This issue

Research Paper

Liver function recovery of COVID-19 patients after discharge, a follow-up study

Ya-Wen An1*, Shuo Song1*, Wei-Xin Li2*, Yong-Xin Chen2, Xiao-Peng Hu1, Jia Zhao1, Zhi-Wen Li1, Guang-Yu Jiang2, Cheng Wang2, Jian-Chun Wang1✉, Bo Yuan2✉, Han-Qing Liu1✉

1. Central laboratory, Shenzhen Samii Medical Center, Shenzhen city, Guangdong province, China, 518118.
2. Neurology department, Shenzhen Samii Medical Center, Shenzhen city, Guangdong province, China, 518118.
*These authors contributed equally to this work.

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Citation:
An YW, Song S, Li WX, Chen YX, Hu XP, Zhao J, Li ZW, Jiang GY, Wang C, Wang JC, Yuan B, Liu HQ. Liver function recovery of COVID-19 patients after discharge, a follow-up study. Int J Med Sci 2021; 18(1):176-186. doi:10.7150/ijms.50691. Available from https://www.medsci.org/v18p0176.htm

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Abstract

Objective: The aim of this study was to observe the liver function recovery of COVID-19 patients after discharge.

Patients and Methods: A total of 253 discharged COVID-19 patients in Shenzhen city, China were selected. The clinical characteristics of these patients were assessed. A 2-month follow-up and laboratory hematology test were performed to examine the status of patients' liver function.

Results: Patients combined with liver diseases, especially fatty liver, are more likely to progress to severe condition (P<0.05). Patients in severe condition and those with liver diseases have higher rates of liver injuries during hospitalization, characterized by a significant increase in alanine aminotransferase (ALT) and aspartate aminotransferase (AST, P<0.01). The ALT, AST/ALT, gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP), total protein (TP), albumin (ALB), and A/G levels showed significant differences in comparison with the control group (P<0.05, and P<0.001); and the outlier ratio of A/G, ALT, GGT and ALP of patients remained abnormal higher within 14 days after discharge (P<0.001). Liver injuries of COVID-19 patients may be related to the epidemiological characteristics, clinical indexes, basic diseases, symptoms, drug treatment during hospitalization and the complications. Indicators of liver function were correlated with cardiac function, renal function, thyroid function, lipid metabolism, glucose metabolism, immune index, leukocyte, erythrocyte, hemoglobin and platelet related indexes. The outlier ratio of TP, ALB and GLB remained extremely low throughout the follow-up period; the outlier ratio of ALT, AST and GGT decreased below 10% from a high level at 40 days after discharged. However, the outlier ratio of A/G, AST/ALT and ALP remained high during the follow-up period.

Conclusions: Abnormal liver function might indicate worse recovery of COVID-19 patients. Changes in liver function should be emphasized during long-term follow-up of COVID-19 patients after hospital discharge; the necessity of employing appropriate interventions for liver function repair should be emphasized.

Keywords: COVID-19 pneumonia, liver injury, discharge management, follow-up