Impact of COVID-19 on liver function: results from an internal medicine unit in Northern Italy
Authors: Lenti Marco Vincenzo , Borrelli de Andreis Federica , Pellegrino Ivan , Klersy Catherine , Merli Stefania , Miceli Emanuela , Aronico Nicola , Mengoli Caterina , Di Stefano Michele , Cococcia Sara , Santacroce Giovanni , Soriano Simone , Melazzini Federica , Delliponti Mariangela , Baldanti Fausto , Triarico Antonio , Corazza Gino Roberto , Pinzani Massimo , Di Sabatino Antonio ,   the Internal Medicine Covid-19 Team, Bergamaschi Gaetano , Bertolino Giampiera , Codega Silvia , Costanzo Filippo , Cresci Roberto , Derosa Giuseppe , Falaschi Francesco , Iadarola Carmine , Lovati Elisabetta , Lucotti Pietro Carlo , Martignoni Alessandra , Mugellini Amedeo , Muggia Chiara , Noris Patrizia , Pagani Elisabetta , Palumbo Ilaria , Pecci Alessandro , Perrone Tiziano , Pieresca Carla , Preti Paola Stefania , Russo Mariaconcetta , Sgarlata Carmelo , Siciliani Luisa , Staniscia Andrea , Torello Vjera Francesca , Achilli Giovanna , Agostinelli Andrea , Antoci Valentina , Ballesio Alessia , Banfi Francesco , Barteselli Chiara , Benedetti Irene , Brattoli Michele , Calabretta Francesca , Cambiè Ginevra , Canta Roberta , Conca Federico , Coppola Luigi , Cremonte Elisa Maria , Croce Gabriele , Del Rio Virginia , Di Terlizzi Francesco , Ferrari Maria Giovanna , Ferrari Sara , Fiengo Anna , Forni Tommaso , Freddi Giulia , Frigerio Chiara , Fumoso Federica , Fusco Alessandra , Gabba Margherita , Garolfi Matteo , Gentile Antonella , Gori Giulia , Grandi Giacomo , Grimaldi Paolo , Lampugnani Alice , Lapia Francesco , Lepore Federica , Lettieri Gianluca , Mambella Jacopo , Mercanti Chiara , Mordà Francesco , Nardone Alba , Pace Luca , Padovini Lucia , Parodi Alessandro , Pitotti Lavinia , Reduzzi Margherita , Rigano Giovanni , Rotola Giorgio , Sabatini Umberto , Salvi Lucia , Santacroce Giovanni , Savioli Jessica , Soriano Simone , Spataro Carmine , Stefani Debora 
Published: July 2020

Little is known regarding coronavirus disease 2019 (COVID-19) clinical spectrum in non-Asian populations. We herein describe the impact of COVID-19 on liver function in 100 COVID-19 consecutive patients (median age 70 years, range 25–97; 79 males) who were admitted to our internal medicine unit in March 2020. We retrospectively assessed liver function tests, taking into account demographic characteristics and clinical outcome. A patient was considered as having liver injury when alanine aminotransferase (ALT) was > 50 mU/ml, gamma-glutamyl transpeptidase (GGT) > 50 mU/ml, or total bilirubin > 1.1 mg/dl. Spearman correlation coefficient for laboratory data and bivariable analysis for mortality and/or need for intensive care were assessed. A minority of patients (18.6%) were obese, and most patients were non- or moderate-drinkers (88.5%). Liver function tests were altered in 62.4% of patients, and improved during follow-up. None of the seven patients with known chronic liver disease had liver decompensation. Only one patient developed acute liver failure. In patients with altered liver function tests, PaO2/FiO2 < 200 was associated with greater mortality and need for intensive care (HR 2.34, 95% CI 1.07–5.11,p = 0.033). To conclude, a high prevalence of altered liver function tests was noticed in Italian patients with COVID-19, and this was associated with worse outcomes when developing severe acute respiratory distress syndrome.