Evaluating the Prognostic Significance of Hepatic Marker Variations in Covid-19 Patients: A Cross-Sectional Analysis in Sabzevar, Iran Publisher



Dalouei SAS ; Molavi M ; Amin B ; Amiri P ; Mahdavifar N
Source: Coronaviruses Published:2025

Abstract

Background: Since the emergence of COVID-19 in early 2020, increased hepatic markers have been reported, indicating potential vulnerability and predictive value for patient outcomes. Hence, this study investigated the impact of COVID-19 on liver function markers and their association with clinical outcomes. Methods: In this cross-sectional study, 392 PCR or CT-Scan confirmed COVID-19 patients from Sabzevar and Mashhad, Iran, were categorized into outpatients, mild-to-moderate, and severe hospitalization groups. Liver enzymes, including AST, ALT, and ALP, were measured, and their associations with disease severity and outcomes were analyzed. Results: Of the participants, 130 were outpatients, and 262 were hospitalized, with a higher male predominance in severe cases. Inpatients showed significantly elevated ALP compared to outpatients. Severe inpatients exhibited higher initial blood sugar levels and longer hospital stays. Elevated AST and ALT levels were notable in ICU admissions and patients requiring mechanical ventilation. A significant difference in pre-admission AST levels was observed between deceased and recovered patients. No correlation was found between liver enzymes and factors like gender, blood oxygen level, respiratory rate, fever, and BMI. Conclusion: Elevated liver enzymes, particularly AST and ALT, are indicative of COVID-19 severity and can predict the need for intensive care and mechanical ventilation. AST levels may also serve as a prognostic marker for patient outcomes. These findings highlight the importance of monitoring liver function in COVID-19 management. © 2025 Elsevier B.V., All rights reserved.