Clinical Characteristics of Non-ICU Hospitalized Patients With Coronavirus Disease 2019 and Liver Injury

A Retrospective Study

Hansheng Xie; Jianming Zhao; Ningfang Lian; Su Lin; Qunfang Xie; Huichang Zhuo


Liver International. 2020;40(6):1321-1326. 

In This Article

Abstract and Introduction


Background & Aims: Coronavirus disease 2019 (COVID-19) has raised world concern for global epidemic since December, 2019. Limited data are available for liver function in COVID-19 patients. We aimed to investigate the risk factors related to liver injury in the COVID-19 patients.

Methods: A retrospective study was performed in non-ICU Ward at Jinyintan Hospital from February 2, 2020 to February 23, 2020. Consecutively confirmed COVID-19 discharged cases were enrolled. The clinical characteristics of patients with liver injury and without liver injury were compared.

Results: A total of 79 COVID-19 patients were included. 31.6%, 35.4% and 5.1% COVID-19 patients had elevated levels of alanine transaminase (ALT), aspartate aminotransferase (AST) and bilirubin respectively. Median value of ALT, AST and bilirubin for entire cohort was 36.5 (17.5 ~ 71.5) U/L, 34.5 (25.3 ~ 55.3) U/L and 12.7 (8.1 ~ 15.4) mmol/L respectively. There were no significant differences in age, previous medical history and symptoms between the two groups. Males were more likely to have liver injury when infected with COVID-19 (P < .05); compared with patients without liver injury, patients with liver injury had increased levels of white blood cell counts, neutrophils, CRP and CT score (P < .05) and had a longer length of stay (P < .05). Logistic regression analyses suggested that the extent of pulmonary lesions on CT was a predictor of liver function damage (P < .05).

Conclusions: Liver injury is common in non-ICU hospitalized COVID-19 patients. It may be related to systemic inflammation. Intense monitoring and evaluation of liver function in patients with severe pulmonary imaging lesions should be considered.


Coronavirus disease 2019 (COVID-19) was first diagnosed in Wuhan, Hubei province in China in 2019 and subsequently spread worldwide. Spread of COVID-19 is via airborne droplets, intimate contact, etc and infection results in pneumonia.[1,2] COVID-19 was documented in approximately 80 000 persons in China, resulting in more than 2800 deaths by the end of February 2020. Now COVID-19 is an ongoing public health emergency of international significance. Previous studies have found that ICU patients with COVID-19 had high risk for liver injury, but the cause of liver injury was not further analysed.[3,4] In addition, previous studies had focused on liver injury in ICU patients, but less focused on non-ICU patients. This retrospective study included patients with confirmed COVID-19 in general ward, and intended to explore the possible influencing factors of liver injury and provided further information for mechanism.