Liver dysfunction in adult COVID-19 infection—a comparison of the delta variant and predecessor strains

Background and Aims

Multiple factors are responsible for severe acute respiratory syndrome coronavirus 2 (SARS-CoV 2)-associated liver dysfunction. The impact of variants of concern (VoCs) on liver function is less clear. The aims were to determine (1) the prevalence and risk of abnormal liver biochemistry (ALB) and liver injury (LI) and (2) differences in ALB and LI with the Delta variant compared with wild-type and VoCs before Delta variant coronavirus disease of 2019 (COVID-19) infections in Malaysian adults.

Methods

This prospective single-center, observational study enrolled adults hospitalized for COVID-19 infection between 1 February 2020 and 30 October 2021 using a convenience sampling method. Patients with COVID-19 confirmed by real-time reverse-transcriptase polymerase chain reaction of nasal and pharyngeal swabs and having at least one liver function test were recruited and assigned to cohort A (wild-type strain and all VoCs before the Delta variant) or cohort B (Delta variant).

Results

Of 1,246 patients with COVID-19 infection, 58.7% developed ALB and 26.6% developed LI. Multivariate analysis showed that men, moderate and severe disease, and underlying chronic liver disease (CLD) were associated with ALB and LI. Patients with the Delta variant had a significantly higher risk of developing both ALB (71.6% vs. 48.5%, p < 0.001) and LI (38.8% vs. 17.1%, p < 0.001) compared with previous strains.

Conclusions

ALB was more common than LI, but LI was more frequent in men with underlying CLD, and in those with moderate or severe COVID-19 infections. Patients with Delta variant infections were more likely to have ALB and LI than those with precedent strains.

Full text

https://www.xiahepublishing.com/2994-8754/JTG-2023-00034

The study was recently published in the Journal of Translational Gastroenterology.

Journal of Translational Gastroenterology (JTG) dedicates to improving clinical diagnosis and treatment, advancing understanding of the molecular mechanisms, and promoting translation from bench to bedside of gastrointestinal, hepatobiliary, and pancreatic diseases. The aim of JTG is to provide a forum for the exchange of ideas and concepts on basic, translational, and clinical aspects of gastroenterology, and promote cross-disciplinary research and collaboration.

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