| Abstrakt: |
Background: The coronavirus disease 2019 (COVID-19) started in December of 2019 as a cluster of pneumonia cases of unclear etiology in Wuhan city of Hubei province in China. Later, it was found to be caused by a coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The disease rapidly spread throughout the world, becoming a pandemic, and as of April, 2022, there were more than 500 million cases worldwide with more than 6 million deaths. It is postulated that the virus enters the human body by binding to the angiotensin-converting enzyme receptor-2 (ACE-2) with the help of spike protein on its cell membrane. Aim of the Work: To compare the serum liver chemistries such as hepatic transaminases to evaluate whether they can predict severity and mortality in COVID-19. Patients and Methods: A comparative cross-sectional study for 6 months in Ain-Shams University hospitals, we studied 100 hospitalized patients with confirmed COVID-19 by RT-PCR for SARS-CoV-2. They included 70 patients with non-severe COVID-19 and 30 patients with severe COVID-19 on hospital admission. This classification was based on the quick COVID-19 severity index (qCSI) and CT-severity index. Results: The results of our study showed that levels of inflammatory markers such as CRP, serum ferritin, d-dimer, and pro-calcitonin were significantly higher in the severe group when compared to the non-severe group. This could be an indicator of a more intense inflammatory state in patients with severe COVID-19 admitted to ICU. Our study showed that 40% of the severe group admitted to the ICU passed away. In our study, the median levels for ALT, AST at admission were 51 and 46 U/L, respectively, which are considered higher than the upper limit of normal levels. Our study showed that during hospitalization, the group of patients with severe COVID-19 who were admitted to ICU had significantly higher prevalence of abnormal ALT levels when compared to the non-severe group (86% versus 32%, respectively). Conclusion: Our study showed that patients with severe COVID-19 have significantly higher levels of AST and ALT and that, on admission, patients with abnormal ALT and AST levels have significantly higher odds for developing severe COVID-19 compared to patients with normal levels. We confirm the importance of monitoring liver enzymes in hospitalized patients with COVID-19 as patients with abnormally elevated AST and ALT are more expected to progress to severe COVID-19 which have prognostic implications in the COVID-19 disease course. [ABSTRACT FROM AUTHOR] |
