Title: IDDF2020-ABS-0168 Prevalence of elevated liver enzyme in Covid-19 and its association with disease outcome
Abstract: <h3>Background</h3> Coronavirus Disease 19 (Covid-19) had previously been thought to affect mainly respiratory organs. Recent studies had shown that this disease might impact another organ as well, including the liver. Coronavirus has recently been found to be able to bind angiotensin-converting enzyme 2 (ACE2) on cholangiocytes, Leading to cell dysfunction and inflammatory response leading to liver injury. Previous studies had shown that abnormal liver function can be detected in 14% to 53% of Covid-19 cases and was related to increased risk of mortality. We aim to evaluate liver enzyme abnormality in Covid-19 patients and its association with disease outcome. <h3>Methods</h3> We conducted a retrospective analysis of all confirmed Covid-19 cases from hospitals of Siloam Hospital Group in Indonesia from 6 March until 15 July 2020. Data with unavailable liver enzyme were excluded. <h3>Results</h3> We collected data from 266 patients with positive rt-PCR for Covid-19. A total of 81 patients (30.5%) had elevated liver enzyme on admission, with abnormal liver enzyme was defined as serum Alanine Aminotransferase (ALT) value >35 IU/L. Median ALT was 19 IU/L in the normal ALT group and 52 IU/L in the elevated ALT group. Patients in both groups had similar characteristics in age (median 44 vs 47-year-old) and sex distribution (male percentage 69.1% vs 46.5%). The total mortality rate from all patient was 8.3%. Risk of mortality was higher in patients with elevated ALT on admission compared to those with normal ALT (11.1% vs 7.0%, OR: 1.65, 95% CI: 0.67–4.04, p: 0.266) but this increase is not statistically significant. Patients with elevated ALT also had a statistically significant higher risk of Intensive Care Unit admission (21.0% vs 8.6%, OR: 2.81, 95% CI: 1.34–5.88, p<0.01). The average length of stay was similar between both groups (median 11 days vs 11 days, p: 0.612). <h3>Conclusions</h3> Elevated liver enzyme on admission could be found in a significant proportion of Covid-19 patients and was associated with non-statistically significant increased risk of mortality.