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Abstract
Emerging evidence suggest association of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection with the development of many liver abnormalities. The overarching aim of this study was therefore to assess the available evidence on the clinical effects of SARS-CoV-2 on the profiles of liver chemistries and coagulation in COVID-19 diagnosed patients. We considered all study designs including epidemiological and observational that reported liver function test abnormalities in patients confirmed with SARS-CoV-2 infection. Medline, Embase databases and Google Scholar as well as relevant reviews were searched to identify appropriate studies from inception to 31st of August 2020. We calculated the pooled mean with 95% confidence intervals (95% CI) through a random-effect model meta-analysis. A total of 35 studies with 10,692 participants were considered for the review from which 23 studies with sufficient quantitative data were included in the meta-analysis. The pooled mean for liver enzymes and coagulation parameters did not significantly change in patients diagnosed with COVID-19 and remained within normal range. Notwithstanding potential bias from confounding factors in interpretation of data in this review, findings from the observational studies and case reports suggest that COVID-19 does not appear to have a significant impact on the transaminases or total bilirubin levels of patients with confirmed SARS-CoV-2 infection. Further controlled studies and larger sample size observational studies are needed with adequate reporting of other liver function parameters are warranted.
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1 King Faisal Specialist Hospital & Research Center, Department of Liver & Small Bowel Transplantation & Hepatobiliary-Pancreatic Surgery, Riyadh, Saudi Arabia (GRID:grid.415310.2) (ISNI:0000 0001 2191 4301)
2 Salmaniya Medical Complex, Internal Medicine Department, Manama, Bahrain (GRID:grid.416646.7) (ISNI:0000 0004 0621 3322)
3 Ibn AlNafees Hospital, Manama, Bahrain (GRID:grid.416646.7)
4 RMIT University, School of Science, Melbourne, Australia (GRID:grid.1017.7) (ISNI:0000 0001 2163 3550)
5 AlFaisal University, Organ Transplant Center & Department of Surgery, King Faisal Specialist Hospital & Research Centre (Gen. Org) MBC 96, Riyadh, Saudi Arabia (GRID:grid.411335.1) (ISNI:0000 0004 1758 7207)