COVID-19 Research Paper Volume 12, Issue 19 pp 18844—18852

Analysis of liver injury factors in 332 patients with COVID-19 in Shanghai, China

Hongying Guo1, *, , Zhengguo Zhang1, *, , Yuyi Zhang1, , Yu Liu1, , Jiefei Wang1, , Zhiping Qian1, , Ying Zou1, , Hongzhou Lu2, ,

  • 1 Department of Severe Hepatopathy, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
  • 2 Department of Infectious Disease and Immunology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
* Equal contribution

Received: May 6, 2020       Accepted: July 21, 2020       Published: October 1, 2020
How to Cite

Copyright: © 2020 Guo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Objective: We analyzed clinical parameters and risk factors for coronavirus disease 2019 (COVID-19)-related liver damage.

Results: Of the 332 COVID-19 patients, 306 and 26 were included in the non-critical and critical groups, respectively. The median time from onset to admission was 4.0 (2.0–8.0) days. Of the 332 COVID-19 patients, 98 (29.5%) were admitted with liver injury. The rates of aspartate transaminase, γ-glutamyl transpeptidase, and total bilirubin abnormalities were higher in the critical group than in the non-critical group. The patient’s sex, COVID-19 severity, and a low liver CT density strongly correlated with liver injury (ORs: 2.936, 6.543, and 3.387, respectively). Statistical analysis on drug administration after admission showed that the usage rates of lopinavir/ritonavir, glucocorticoids, and thymopeptides were significantly higher in the abnormal group than the normal groups (p<0.05).

Conclusions: Though not severe, the liver injury among COVID-19 patients was pervasive. Being male, COVID-19 severity, low CT density, and medications may be risk factors for liver damage. Following recovery, liver function gradually returns to normal.

Methods: This retrospective study screened 332 confirmed COVID-19 patients from January 20 to March 13, 2020. Liver indicators were evaluated on admission. The risk factors, medications, and the dynamic change of liver functions were analyzed.


COVID-19: coronavirus disease 2019; SARS-CoV-2: severe acute respiratory syndrome coronavirus 2; ALT: alanine aminotransferase; AST: aspartate transaminase; total bilirubin; ALP: alkaline phosphatase; γ-GT: γ-glutamyl transpeptidase; TB: total bilirubin.