Elevated Transaminases as Predictors of COVID-19 Pneumonia Severity

• Published in: Medicina
• Main Authors: Tijana Radonjić, Ognjen Milićević, Igor Jovanović, Marija Zdravković, Marija Dukić, Olga Milorad Mandić, Jelica Bjekić-Macut, Olivera Borko Marković, Zoran Todorović, Milica Brajković, Novica Nikolić, Slobodan Klašnja, Višeslav Popadić, Anica Divac, Milica Marinković, Nabil Alhayek, Marija Svetislav Branković
• Format: Article
• Language: English
• Published: MDPI AG 2022-06-01
• Subjects: liver; transaminases; COVID-19; SARS-CoV-2
• Online Access: https://www.mdpi.com/1648-9144/58/7/842
• ISSN: 1010-660X; 1648-9144

Background: This study aimed to calculate the frequency of elevated liver enzymes in hospitalized patients with coronavirus disease 2019 (COVID-19) infection and to test if liver enzyme biochemistry levels on admission could predict the computed tomography (CT) scan severity score of bilateral interstitial pneumonia. Methods: This single-center study comprised of 323 patients including their demographic data, laboratory analyses, and radiological findings. All the information was taken from electronic health records, followed by statistical analysis. Results: Out of 323 patients, 115 of them (35.60%) had aspartate aminotransferase (AST) and/or alanine aminotransferase (ALT) over 40 U/L on admission. AST was the best predictor of CT scan severity score of bilateral interstitial pneumonia (R² = 0.313, Adjusted R² = 0.299). CT scan severity score in the peak of the infection could be predicted with the value of AST, neutrophils, platelets, and monocytes count (R² = 0.535, Adjusted R² = 0.495). Conclusion: AST, neutrophils, platelets, and monocytes count on admission can account for almost half (49.5%) of the variability in CT scan severity score at peak of the disease, predicting the extensiveness of interstitial pneumonia related to COVID-19 infection. Liver enzymes should be closely monitored in order to stratify COVID-19 patients with a higher risk of developing severe forms of the disease and to plan the beforehand step-up treatment.