Baseline aspartate aminotransferase activity is closely related to COVID-19 mortality: A bidirectional cohort study

Salah Ahmed, Saba; Modawe, GadAllah; Abdelrahman, Suhair

doi:10.61186/rabms.9.3.154

Volume 9, Issue 3 (7-2023) Journal of Research in Applied and Basic Medical Sciences 2023, 9(3): 154-160 | Back to browse issues page

‎ 10.61186/rabms.9.3.154

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Salah Ahmed S, Modawe G, Abdelrahman S. Baseline aspartate aminotransferase activity is closely related to COVID-19 mortality: A bidirectional cohort study. Journal of Research in Applied and Basic Medical Sciences 2023; 9 (3) :154-160
URL: http://ijrabms.umsu.ac.ir/article-1-264-en.html

Baseline aspartate aminotransferase activity is closely related to COVID-19 mortality: A bidirectional cohort study

Saba Salah Ahmed

, GadAllah Modawe

, Suhair Abdelrahman ^*

Department of Clinical Chemistry, Faculty of Medical Laboratory Sciences, Al Neelain University, Khartoum, Sudan , suhair2022@neelain.edu.sd

Abstract: (716 Views)

Background & Aims: The coronavirus disease 2019 (COVID-19) outbreak has become a global public health pandemic, and many deaths occurred in a short period. It is possible for coronaviruses to cause hepatic injury, and the dying patient may complain about it. Aim of this study was to compare the liver function parameters, and demographic, clinical, and laboratory results between survivors and non-survivors of COVID-19.
Materials & Methods: This was a retrospective-prospective cohort study conducted at Universal Hospital in Sudan. The Study included 80 cases of coronaviruse infected patients, of them 43 (53.7%) were female and 37 (46.3%) were male. A structured questionnaire was used to collect demographic, clinical, and results of liver function tests on the first day of admission. Patients were divided into survivors (treated and discharged) and non-survivors (died) groups, according to their outcomes. The analysis of the questionnaire was done using SPSS version 25.
Results: Out of the 80 coronaviruse infected patients, 35 (43.8%) were survivors while the remaining 45 (56.2%) were non-survivors. The results revealed a significant increase in the mean levels of AST (p. value= 0.001), ALT (p. value= 0.047), and decreased levels of Albumin (p. value= 0.009) in the Non-survivor group compared to the survivors' group. The regression analysis demonstrated a significant correlation between AST (p value =0.04) and albumin (p value=0.02) with COVID-19 death. In the Receiver Operation Curve (ROC) analysis, the Area Under the Curve (AUC) value of the AST was 0.70 (p=0.002) with sensitivity and specificity of 73% and 66%, respectively.
Conclusion: The Study concluded that baseline AST level was significantly correlated with the mortality of COVID-19 patients.

Keywords: Aspartate Aminotransferase, Coronavirus, COVID-19, Liver Function

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Type of Study: orginal article | Subject: Other

References

1. Gorbalenya AE, Baker SC, Baric RS, de Groot RJ, Drosten C, Gulyaeva AA, et al. The species Severe acute respiratory syndrome-related coronavirus: classifying 2019-nCoV and naming it SARS-CoV-2. Nat Microb 2020;5(4):536-44. [DOI:10.1038/s41564-020-0695-z] [PMID] []

2. Fan Z, Chen L, Li J, Cheng X, Yang J, Tian C, et al. Clinical Features of COVID-19-Related Liver Functional Abnormality. Clin Gastroenterol Hepatol 2020;18(7):1561-6. [DOI:10.1016/j.cgh.2020.04.002] [PMID] []

3. Siregar GA, Siregar GP, Darmadi D, Ruslie RH. Coronavirus disease-19 and liver injury. Open Access Maced J Med Sci 2020;8(T1):154-7. [DOI:10.3889/oamjms.2020.5028]

4. Worldometers.info. (2021). Sudan Population (2021) - Worldometer. [online] Available at: [Accessed 11 December 2020]. [URL]

5. Musa TH, El-Bingawi H, Musa IH, Mohammed LA, Arbab MA, Musa HH. COVID-19 in Sudan: Response towards control and prevention. Med J Malaysia 2020:403-5. [DOI:10.1016/j.jemep.2020.100604] [PMID] []

6. FMOH. epidemic report. Available from: https://fmoh.gov.sd/index.php/files/download/334. Acceded: 15 janu 2023.

7. Vespa E, Pugliese N, Piovani D, Capogreco A, Danese S, Aghemo A. Liver tests abnormalities in COVID-19: trick or treat? J Hepatol 2020;73(5):1275-6. [DOI:10.1016/j.jhep.2020.05.033] [PMID] []

8. Chai X, Hu L, Zhang Y, Han W, Lu Z, Ke A, et al. Specific ACE2 expression in cholangiocytes may cause liver damage after 2019-nCoV infection. Biorxiv 2020:2020.02. 03.931766. [DOI:10.1101/2020.02.03.931766]

9. Guan W-j, Ni Z-y, Hu Y, Liang W-h, Ou C-q, He J-x, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020;382(18):1708-20. [DOI:10.1056/NEJMoa2002032] [PMID] []

10. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020;395(10223):507-13. https://doi.org/10.1016/S0140-6736(20)30211-7 [DOI:10.1016/s0140-6736(20)30211-7] [PMID]

11. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. Jama 2020;323(11):1061-9. [DOI:10.1001/jama.2020.1585] [PMID] []

12. Vahey GM, Marshall KE, McDonald E, Martin SW, Tate JE, Midgley CM, et al. Symptom profiles and progression in hospitalized and nonhospitalized patients with coronavirus disease, Colorado, USA, 2020. Emerg Infect Dis 2021;27(2):385. [DOI:10.3201/eid2702.203729] [PMID] []

13. Wang D, Li R, Wang J, Jiang Q, Gao C, Yang J, et al. Correlation analysis between disease severity and clinical and biochemical characteristics of 143 cases of COVID-19 in Wuhan, China: a descriptive study. BMC Inf Dis 2020;20:1-9. [DOI:10.1186/s12879-020-05242-w] [PMID] []

14. Huang J, Cheng A, Kumar R, Fang Y, Chen G, Zhu Y, et al. Hypoalbuminemia predicts the outcome of COVID‐19 independent of age and co‐morbidity. J Med Virol 2020;92(10):2152-8. [DOI:10.1002/jmv.26003] [PMID] []

15. Sun J, Aghemo A, Forner A, Valenti L. COVID-19 and liver disease. Liver Int 2020;40(6):1278-81. [DOI:10.1111/liv.14470] [PMID]

16. Li J, Li M, Zheng S, Li M, Zhang M, Sun M, et al. Plasma albumin levels predict risk for nonsurvivors in critically ill patients with COVID-19. Biomarkers Med 2020;14(10):827-37. [DOI:10.2217/bmm-2020-0254] [PMID] []

17. Soeters PB, Wolfe RR, Shenkin A. Hypoalbuminemia: pathogenesis and clinical significance. J Parenter Enteral Nutr 2019;43(2):181-93. [DOI:10.1002/jpen.1451] [PMID] []

18. Aziz M, Fatima R, Lee-Smith W, Assaly R. The association of low serum albumin level with severe COVID-19: a systematic review and meta-analysis. Crit Care 2020;24(1):255. [DOI:10.1186/s13054-020-02995-3] [PMID] []

19. Giannini EG, Testa R, Savarino V. Liver enzyme alteration: a guide for clinicians. Can Med Assoc J 2005;172(3):367-79. [DOI:10.1503/cmaj.1040752] [PMID] []

20. Lippi G, Henry BM, Bovo C, Sanchis-Gomar F. Health risks and potential remedies during prolonged lockdowns for coronavirus disease 2019 (COVID-19). Diagnosis 2020;7(2):85-90. [DOI:10.1515/dx-2020-0041] [PMID]