the interrelationship between liver function test and the novel coronavirus disease 2019: a systematic review and meta-analysis

Background: the outbreak of the coronavirus disease-2019 (covid-19) has become a global public health challenge. assessing the effect of covid-19 on liver injury is of great importance. a systematic review and meta-analysis were conducted to establish the characteristics of liver function tests in covid-19 patients. methods: a systematic search of publications from december 2019 up to april 2020 in web of science, scopus, and medline (via pubmed) databases was performed. both cross- sectional and case series studies reporting an association between liver injury and covid-19 infection were included. the data were analyzed using the stata software (version 11.0) and the random-effects model for i^2>50% was used to pool the results. results: in this meta-analysis, 42 articles comprising a total of 6,557 covid-19 patients were studied. the prevalence of increase in alanine aminotransferase (alt) and aspartate aminotransferase (ast) levels was 30% and 21% in non-severe patients and 38% and 48% in severe patients, respectively. patients with severe covid-19 infection were 4.22, 4.96, and 4.13 times more likely to have elevated ast, alt, and lactate dehydrogenase (ldh) levels, respectively. conclusion: elevation in liver function tests was higher in patients with severe than non-severe covid-19 infection. given the widespread use of drugs that increases the risk of hepatotoxicity, healthcare providers should be aware of changes in liver enzymes in covid-19 patients. the inclusion of other studies from outside china could confirm the pattern of elevation in liver function tests in covid-19 patients across the globe.