Elevated Liver Enzymes along with Comorbidity Is a High Risk Factor for COVID-19 Mortality: A South

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Background and Aims: Liver enzyme abnormalities in coronavirus 2019 (COVID-19) are being addressed in the literature. The predictive risk of elevated liver enzymes has not been established for COVID-19 mortality. In this study, we hypothesized that elevated liver enzymes at ad-mission can predict the outcome of COVID-19 disease with other known indicators, such as comorbidities. Methods: This retrospective study included all the consecutive hos-pitalized patients with confirmed COVID-19 disease from March 4th to May 31st, 2020. The study was conducted in Rajiv Gandhi Government General Hospital, Chennai, Ta-mil Nadu, India. We assessed demography, clinical vari-ables, COVID-19 severity, laboratory parameters, and out-come. Results: We included 1,512 patients, and median age was 47 years (interquartile range: 34–60) with 36.9% being female. Liver enzyme level (aspartate aminotrans-ferase and/or alanine aminotransferase) was elevated in 450/1,512 (29.76%) patients. Comorbidity was present in 713/1,512 (47.16%) patients. Patients with liver enzymes\' elevation and presence of comorbidity were older, more frequently hospitalized in ICU and had more severe symp-toms of COVID-19 at the time of admission. Presence of liver enzymes\' elevation with comorbidity was a high risk factor for death (OR: 5.314, 95% CI: 2.278–12.393), as compared to patients with presence of comorbidity (OR: 4.096, 95% CI: 1.833–9.157). Conclusions: Comorbid-ity combined with liver enzymes\' elevation at presentation independently increased the risk of death in COVID-19 by at least 5-fold.
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