Original Article

Liver Biomarkers Assay in COVID-19 Cases: A Comparison Study between Alive and Dead Patients

Abstract

Background: Identifying effective biomarkers plays a critical role on screening; rapid diagnosis; proper managements and therapeutic options, which is helpful in preventing serious complications. The present study aimed to compare the liver laboratory tests between alive and dead hospitalized cases for prediction and proper management of the patients.

Methods: This retrospective, cross sectional study consists of all deceased patients admitted in one center in Shiraz, Iran during 19 Feb 2020 to 22 Aug 2021. For further comparison, we selected a 1:2 ratios alive group randomly.

Results: Overall, 875 hospitalized cases died due to COVID-19. We selected 1750 alive group randomly. The median age was significantly higher in died group (65.96 vs 51.20). Regarding the laboratory findings during the hospitalization ALT, AST, Bili.D were significantly higher in non-survivors than survivors but Albumin was less in deceased patients. It was revealed elevated levels of Albumin, AST, Bili.T and Bili.D were associated with increasing the risk of in hospital death. Moreover, the predictive effect of ALP and Bili.D had significantly more than others with high sensitivity and specify.

Conclusion: We found patients with COVID-19 have reduced serum albumin level, and increase ALT and AST. The current results revealed abnormal liver chemistries is associated with poor outcome, which highlighted the importance of monitoring these patients more carefully and should be given more caution.

1. Sahin A-R, Erdogan A, Agaoglu P-M, et al (2020). 2019 novel coronavirus (COVID-19) outbreak: a review of the current literature. EJMO,4(1):1-7.
2. Habibzadeh P, Sajadi MM, Emami A, et al (2020).Rate of re-positive RT-PCR test among patients recovered from COVID-19. Biochem Med (Zagreb), 30(3):030401.
3. Adhikari SP, Meng S, Wu Y-J, et al (2020). Epidemiology, causes, clinical manifestation and diagnosis, prevention and control of coronavirus disease (COVID-19) during the early outbreak period: a scoping review. Infect Dis Poverty, 9(1):29.
4. Hafeez A, Ahmad S, Siddqui SA, et al (2020). A review of COVID-19 (Coronavirus Disease-2019) diagnosis, treatments and prevention. EJMO ,4(2):116-25.
5. Javanmardi F, Keshavarzi A, Akbari A, et al (2020). Prevalence of underlying diseases in died cases of COVID-19: A systematic review and meta-analysis. PloS One,15(10):e0241265.
6. Taleb S, Yassine HA, Benslimane FA, et al (2021). Predictive biomarkers of ICU and mechanical ventilation duration in critically-ill COVID19 patients. Front Med (Lausanne), 8:733657.
7. Fraser DD, Slessarev M, Martin CM, et al (2020). Metabolomics profiling of critically Ill coronavirus disease 2019 patients: Identification of diagnostic and prognostic biomarkers. Crit Care Explor, 2(10): e0272.
8. Ponti G, Maccaferri M, Ruini C, et al (2020). Biomarkers associated with COVID-19 disease progression. Crit Rev Clin Lab Sci, 1–11.
9. Tjendra Y, Al Mana AF, Espejo AP, et al (2020). Predicting disease severity and outcome in COVID-19 patients: a review of multiple biomarkers. Arch Pathol Lab Med,144(12):1465-1474.
10. Malik P, Patel U, Mehta D, et al (2020). Biomarkers and outcomes of COVID-19 hospitalisations: systematic review and meta-analysis. BMJ Evid Based Med, 26(3):107-108.
11. Emami A, Akbari A, Javanmardi F, et al (2020). Designing a Multicenter Registry of COVID-19 and Other Respiratory Infections in Fars, Iran. Disaster Med Public Health Prep, 6:1-4.
12. Kermali M, Khalsa RK, Pillai K, et al (2020). The role of biomarkers in diagnosis of COVID-19–A systematic review. Life Sci, 254:117788.
13. Organization WH (2020). Clinical management of severe acute respiratory infection (SARI) when COVID-19 disease is suspected: interim guidance, 13 March 2020. World Health Organization
14. Kovalic AJ, Huang G, Thuluvath PJ, et al (2020). Elevated Liver Biochemistries in Hospitalized Chinese Patients with Severe COVID‐19: Systematic Review and Meta‐analysis. Hepatology, 73(4):1521-1530.
15. Dong X, Zeng D-Y, Cai Y-Y, et al (2020). Liver Chemistries in Patients with Severe or Non-Severe COVID-19: a Meta-Analysis. medRxiv, doi: https://doi.org/10.1101/2020.04.24.20074179.
16. Kulkarni AV, Kumar P, Tevethia HV, et al (2020). Systematic review with meta‐analysis: liver manifestations and outcomes in COVID‐19. Aliment Pharmacol Ther, 52(4):584-599.
17. Violi F, Cangemi R, Romiti GF, et al (2020). Is albumin predictor of mortality in COVID-19? Antioxid Redox Signal, 35(2):139-142.
18. Wu C-Y, Hu H-Y, Huang N, et al (2018). Albumin levels and cause-specific mortality in community-dwelling older adults. Prev Med, 112:145-51.
19. Xing QQ, Dong X, Ren YD, et al (2021). Liver Chemistries in Patients With COVID‐19 Who Were Discharged Alive or Died: A Meta‐analysis. Hepatol Commun, 5(1):12-23.
20. Chen T, Wu D, Chen H, et al (2020). Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective study. BMJ, 368:m1091.
Files
IssueVol 51 No 1 (2022) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/ijph.v51i1.8309
Keywords
COVID-19 Liver Biomarkers Death Alive
Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Emami A, Javanmardi F, Akbari A, Shirazi Yeganeh B, Rezaei T, Bakhtiari H, Pirboneyh N. Liver Biomarkers Assay in COVID-19 Cases: A Comparison Study between Alive and Dead Patients. Iran J Public Health. 2022;51(1):172-177.