Liver Enzymes Changes and their Association with Outcome in Hospital Inpatients with COVID-19 in Jordan.

Background: Abnormal levels of liver enzymes have been reported in patients with COVID-19 and severe clinical presentation. However, limited studies exist in our region regarding the impact of COVID-19 on the liver's function. Thus, we aimed to investigate liver enzyme changes and their association with prognosis and outcome in hospitalized patients with COVID-19 in Jordan. Methods: This retrospective cohort study included 359 patients with COVID-19 who were admitted to Ministry of Health hospitals all around Jordan during the second pandemic wave of COVID-19. Data such as liver enzymes, patients demographics, and outcomes were collected and statistically analysed. Results: Approximately 39.6% of infected patients had elevated liver enzymes, and 5.9% had elevated enzymes more than twice the upper limit of normal (ULN). Among these patients, 40.8% had both aspartate aminotransferases (AST) and alanine aminotransferases (ALT) elevation, 52.1% had AST elevation alone, and 7.0% had ALT elevation alone. Factors associated with worse prognosis and outcome were older age, male sex, and comorbid autoimmune conditions. The peak and at-discharge values of AST and ALT showed significant differences. Conclusion: Liver enzyme abnormality is common among patients with COVID-19 and AST is the most common abnormality. AST and ALT elevation can be associated with longer hospital stays, older age, and male sex.