Hepatobiliary manifestations of COVID-19 and their impact on severity and outcomes in a single center in Saudi Arabia
Authors: Al Argan Reem ,   Department of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Khobar, Saudi Arabia,   Reem Al Argan, Department of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Khobar, Saudi Arabia. E-mail: Rjalarqan@iau.edu.sa, Ismail Mona ,   Department of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Khobar, Saudi Arabia, AlKhafaji Dania ,   Department of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Khobar, Saudi Arabia, Alsulaiman Raed ,   Department of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Khobar, Saudi Arabia, Ismaeel Fatimah ,   Department of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Khobar, Saudi Arabia, AlSulaiman Reem ,   Department of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Khobar, Saudi Arabia, Alsheekh Lameyaa ,   Department of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Khobar, Saudi Arabia, Alsaif Tariq ,   Department of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Khobar, Saudi Arabia, Alkuwaiti Feras ,   Department of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Khobar, Saudi Arabia, Al Said Abir ,   Department of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Khobar, Saudi Arabia, Alqatari Safi ,   Department of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Khobar, Saudi Arabia, Alwaheed Abrar ,   Department of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Khobar, Saudi Arabia, Alzaki Alaa ,   Department of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Khobar, Saudi Arabia, Al Wazzeh Marwan ,   Department of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Khobar, Saudi Arabia, AlQuorain Abdulaziz ,   Department of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Khobar, Saudi Arabia
Published: November 2022

Recognizing hepatic manifestations of COVID-19 and their impact on the severity and outcome is crucial in managing this emerging pandemic. However, we lack such reported data in Saudi Arabia regarding this clinical entity. This is a retrospective observational study conducted on 387 patients with COVID-19 disease who were hospitalized at King Fahad Hospital of the University from March-September 2020. The total cohort was divided into two groups: liver and non-liver involvement. Then, the frequency of hepatic manifestations was determined, followed by comparing severity and outcome among the two study groups. A total of 387 patients were included, of which 72.87% had hepatic manifestations. The most prevalent abnormalities were high LDH in 308 (79.58%) followed by AST 205 (52.97%), GGTP 124 (31.26%), ALT 74 (19.12%), PT/INR 66 (17.05%), direct bilirubin 51 (12.40%), total bilirubin 46 (11.88%), and low albumin 48 (12.4%). Univariate analyses showed that liver involvement was significantly associated with severe (31.91%) and critical (34.75%) presentation (P<0.001). Multivariate regression analysis showed that the presence of liver involvement was an independent risk factor for severe or critical COVID-19 disease (OR 2.44; P<0.001), longer hospitalization (OR 2.27; P=0.001), and ICU admission (OR 2.27; P=0.006). The current study showed that liver involvement is common in the setting of COVID-19 disease. Such patients had a higher disease severity and a worse clinical outcome.