Study population and setting
Cases were comprised of all 115 health care workers and family members (>14 years old without hepatitis B infection) with confirmed SARS-CoV-2 infection who were admitted to Zhongnan Hospital of Wuhan University, Wuhan, China, from 1/18/20 to 2/22/20. Controls were 119 patients with community-acquired pneumonia from the same hospital.
Summary of Main Findings
Serum markers of liver dysfunction and inflammation were not significantly elevated in COVID-19 patients relative to community-acquired pneumonia patients. Only the neutrophil-to-lymphocyte ratio was a predictor of COVID-19 severity.
Patients were tested for a wide array of liver function indices. The presence of a control group improves the validity of the analysis.
The sample size is small and comes from a single hospital. There were few (n=31) severe cases of COVID-19. The comparison groups may differ by much more than just disease etiology – healthcare workers and their families represent a different population than the broader patient population. Because the sensitivity of the SAR-CoV-2 diagnostic testing is, as yet, unclear, COVID-19 patients may have been incorrectly classified as having non-COVID pneumonia, thus biasing the results.
This is one of the first studies to focus specifically on liver dysfunction as a manifestation of COVID-19.