A systematic review and meta-analysis of the COVID-19 associated liver injury
Introduction and Objectives: The novel coronavirus disease 2019 (COVID-19) has affected more than 5 million people globally. Data on the prevalence and degree of COVID-19 associated liver injury among patients with COVID-19 remain limited. We conducted a systematic review and meta-analysis to assess...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2020-11-01
|
| Series: | Annals of Hepatology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1665268120301617 |
| _version_ | 1819103152403644416 |
|---|---|
| author | Yu Jun Wong Malcolm Tan Qishi Zheng James Weiquan Li Rahul Kumar Kwong Ming Fock Eng Kiong Teo Tiing Leong Ang |
| author_facet | Yu Jun Wong Malcolm Tan Qishi Zheng James Weiquan Li Rahul Kumar Kwong Ming Fock Eng Kiong Teo Tiing Leong Ang |
| author_sort | Yu Jun Wong |
| collection | DOAJ |
| description | Introduction and Objectives: The novel coronavirus disease 2019 (COVID-19) has affected more than 5 million people globally. Data on the prevalence and degree of COVID-19 associated liver injury among patients with COVID-19 remain limited. We conducted a systematic review and meta-analysis to assess the prevalence and degree of liver injury between patients with severe and non-severe COVID-19. Methods: We performed a systematic search of three electronic databases (PubMed/MEDLINE, EMBASE and Cochrane Library), from inception to 24th April 2020. We included all adult human studies (>20 subjects) regardless of language, region or publication date or status. We assessed the pooled odds ratio (OR), mean difference (MD) and 95% confidence interval (95%CI) using the random-effects model. Results: Among 1543 citations, there were 24 studies (5961 subjects) which fulfilled our inclusion criteria. The pooled odds ratio for elevated ALT (OR = 2.5, 95%CI: 1.6-3.7, I2 = 57%), AST (OR = 3.4, 95%CI: 2.3-5.0, I2 = 56%), hyperbilirubinemia (OR = 1.7, 95%CI: 1.2-2.5, I2 = 0%) and hypoalbuminemia (OR = 7.1, 95%CI: 2.1-24.1, I2 = 71%) were higher subjects in critical COVID-19. Conclusion: COVID-19 associated liver injury is more common in severe COVID-19 than non-severe COVID-19. Physicians should be aware of possible progression to severe disease in subjects with COVID-19-associated liver injury. |
| first_indexed | 2024-12-22T01:45:55Z |
| format | Article |
| id | doaj.art-3c02d7ed4b2042c4925ba5f8bd135927 |
| institution | Directory Open Access Journal |
| issn | 1665-2681 |
| language | English |
| last_indexed | 2024-12-22T01:45:55Z |
| publishDate | 2020-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Annals of Hepatology |
| spelling | doaj.art-3c02d7ed4b2042c4925ba5f8bd1359272022-12-21T18:43:05ZengElsevierAnnals of Hepatology1665-26812020-11-01196627634A systematic review and meta-analysis of the COVID-19 associated liver injuryYu Jun Wong0Malcolm Tan1Qishi Zheng2James Weiquan Li3Rahul Kumar4Kwong Ming Fock5Eng Kiong Teo6Tiing Leong Ang7Department of Gastroenterology and Hepatology, Changi General Hospital; Yong Loo Lin School of Medicine, National University of Singapore; Corresponding author at: Department of Gastroenterology and Hepatology, Changi General Hospital, 2, Simei Street 3, 529889, Singapore.Department of Gastroenterology and Hepatology, Changi General Hospital; Yong Loo Lin School of Medicine, National University of SingaporeSingapore Clinical Research Institute; Cochrane SingaporeDepartment of Gastroenterology and Hepatology, Changi General Hospital; Yong Loo Lin School of Medicine, National University of SingaporeDepartment of Gastroenterology and Hepatology, Changi General HospitalDepartment of Gastroenterology and Hepatology, Changi General Hospital; Yong Loo Lin School of Medicine, National University of Singapore; Cochrane SingaporeDepartment of Gastroenterology and Hepatology, Changi General Hospital; Yong Loo Lin School of Medicine, National University of SingaporeDepartment of Gastroenterology and Hepatology, Changi General Hospital; Yong Loo Lin School of Medicine, National University of SingaporeIntroduction and Objectives: The novel coronavirus disease 2019 (COVID-19) has affected more than 5 million people globally. Data on the prevalence and degree of COVID-19 associated liver injury among patients with COVID-19 remain limited. We conducted a systematic review and meta-analysis to assess the prevalence and degree of liver injury between patients with severe and non-severe COVID-19. Methods: We performed a systematic search of three electronic databases (PubMed/MEDLINE, EMBASE and Cochrane Library), from inception to 24th April 2020. We included all adult human studies (>20 subjects) regardless of language, region or publication date or status. We assessed the pooled odds ratio (OR), mean difference (MD) and 95% confidence interval (95%CI) using the random-effects model. Results: Among 1543 citations, there were 24 studies (5961 subjects) which fulfilled our inclusion criteria. The pooled odds ratio for elevated ALT (OR = 2.5, 95%CI: 1.6-3.7, I2 = 57%), AST (OR = 3.4, 95%CI: 2.3-5.0, I2 = 56%), hyperbilirubinemia (OR = 1.7, 95%CI: 1.2-2.5, I2 = 0%) and hypoalbuminemia (OR = 7.1, 95%CI: 2.1-24.1, I2 = 71%) were higher subjects in critical COVID-19. Conclusion: COVID-19 associated liver injury is more common in severe COVID-19 than non-severe COVID-19. Physicians should be aware of possible progression to severe disease in subjects with COVID-19-associated liver injury.http://www.sciencedirect.com/science/article/pii/S1665268120301617SARS-CoV-2 infectionLiver DiseaseAlanine TransaminaseAspartate Aminotransferases |
| spellingShingle | Yu Jun Wong Malcolm Tan Qishi Zheng James Weiquan Li Rahul Kumar Kwong Ming Fock Eng Kiong Teo Tiing Leong Ang A systematic review and meta-analysis of the COVID-19 associated liver injury Annals of Hepatology SARS-CoV-2 infection Liver Disease Alanine Transaminase Aspartate Aminotransferases |
| title | A systematic review and meta-analysis of the COVID-19 associated liver injury |
| title_full | A systematic review and meta-analysis of the COVID-19 associated liver injury |
| title_fullStr | A systematic review and meta-analysis of the COVID-19 associated liver injury |
| title_full_unstemmed | A systematic review and meta-analysis of the COVID-19 associated liver injury |
| title_short | A systematic review and meta-analysis of the COVID-19 associated liver injury |
| title_sort | systematic review and meta analysis of the covid 19 associated liver injury |
| topic | SARS-CoV-2 infection Liver Disease Alanine Transaminase Aspartate Aminotransferases |
| url | http://www.sciencedirect.com/science/article/pii/S1665268120301617 |
| work_keys_str_mv | AT yujunwong asystematicreviewandmetaanalysisofthecovid19associatedliverinjury AT malcolmtan asystematicreviewandmetaanalysisofthecovid19associatedliverinjury AT qishizheng asystematicreviewandmetaanalysisofthecovid19associatedliverinjury AT jamesweiquanli asystematicreviewandmetaanalysisofthecovid19associatedliverinjury AT rahulkumar asystematicreviewandmetaanalysisofthecovid19associatedliverinjury AT kwongmingfock asystematicreviewandmetaanalysisofthecovid19associatedliverinjury AT engkiongteo asystematicreviewandmetaanalysisofthecovid19associatedliverinjury AT tiingleongang asystematicreviewandmetaanalysisofthecovid19associatedliverinjury AT yujunwong systematicreviewandmetaanalysisofthecovid19associatedliverinjury AT malcolmtan systematicreviewandmetaanalysisofthecovid19associatedliverinjury AT qishizheng systematicreviewandmetaanalysisofthecovid19associatedliverinjury AT jamesweiquanli systematicreviewandmetaanalysisofthecovid19associatedliverinjury AT rahulkumar systematicreviewandmetaanalysisofthecovid19associatedliverinjury AT kwongmingfock systematicreviewandmetaanalysisofthecovid19associatedliverinjury AT engkiongteo systematicreviewandmetaanalysisofthecovid19associatedliverinjury AT tiingleongang systematicreviewandmetaanalysisofthecovid19associatedliverinjury |