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Research Article

Comorbid Chronic Diseases and Acute Organ Injuries Are Strongly Correlated with Disease Severity and Mortality among COVID-19 Patients: A Systemic Review and Meta-Analysis

Table 4

Epidemiological characteristics of liver injury in COVID-19 patients.

First author, source, yearLocationNo. of patientsNo. of severe patients (%)Notes

Cao J, Clin Infect Dis, 2020 [27]Wuhan10218 (17.6%)13 cases of acute liver injury from 17 nonsurvivors, 21 cases of acute liver injury from 85 survivors.
Cao M, medRxiv, 2020 [2]Shanghai19819 (9.6%)Compared to non-ICU (moderate) patients, AST, ALT, and total bilirubin were significantly increased in ICU (severe) patients, while albumin was significantly decreased.
Chen G, J Clin Invest, 2020 [82]Wuhan2111 (52.4%)Compared to non-ICU (moderate) patients, AST, ALT, and LDH levels were significantly increased in ICU (severe) patients, while albumin was significantly decreased.
Fan L, medRxiv,2020 [83]Shenyang558 (14.5%)11 cases of liver dysfunction from 47 mild patients, 6 cases of liver dysfunction from 8 severe patients.
Guan W, N Engl J Med, 2020 [13]National1,099173 (15.7%)Increased AST levels in 112 of 615 nonsevere patients, 56 of 142 severe patients, and increased ALT levels in 120 of 606 nonsevere patients, 38 of 135 severe patients.
Huang C, Lancet, 2020 [5]Wuhan4113 (31.7%)Elevated levels of AST were observed in 8 of 13 (61.5%) ICU patients and 7 of 28 (25%) non-ICU patients. Compared to non-ICU patients, ALT levels were significantly increased in ICU patients.
Huang H, medRxiv, 2020 [86]Wuhan12532 (25.6%)Compared to non-ICU (moderate) patients, AST and ALT levels were significantly increased in ICU (severe) patients.
Liu J, medRxiv, 2020 [15]Wuhan4013 (32.5%)Compared to non-ICU (moderate) patients, AST, ALT, and total bilirubin levels were significantly increased in ICU (severe) patients.
Lu H, medRxiv, 2020 [16]Shanghai26522 (8.3%)Compared to non-ICU (moderate) patients, AST, ALT, and LDH levels were significantly increased in ICU (severe) patients, while albumin was significantly decreased.
Wang D, JAMA, 2020 [6]Wuhan13836 (26.1%)Compared to non-ICU (moderate) patients, AST, ALT, prothrombin time, total bilirubin, and LDH were significantly increased in ICU (severe) patients.
Xu YH, medRxiv, 2020 [11]Guangdong4545 (100.0%)12 cases of liver dysfunction from 20 patients required intubation, 5 cases of liver dysfunction from 25 patients did not require intubation.
Yang X, Lancet Respir Med, 2020 [9]Wuhan5252 (100.0%)6 cases of liver dysfunction from 20 survivors, and 9 cases of liver dysfunction from 32 nonsurvivors.
Yao N, Zhonghua Gan Zang Bing Za Zhi, 2020 [26]Shaanxi4017 (42.5%)17 severe patients from 22 ALI cases, and 5 severe patients from 18 cases with normal liver dysfunction.
Zhang GQ, medRxiv, 2020 [10]Wuhan22155 (24.9%)Compared to non-ICU (moderate) patients, AST, ALT, prothrombin time, total bilirubin, and LDH were significantly increased in ICU (severe) patients.

ALI: acute liver injury; ALT: alanine transaminase; AST: aspartate aminotransferase; LDH: lactate dehydrogenase.