ArticleFrontiers in public health2026
Association of inflammatory markers with abnormal liver biochemistry in hospitalized patients with COVID-19: a cross-sectional study.
Article in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Coronavirus disease 2019 (COVID-19) is frequently accompanied by extrapulmonary manifestations, including abnormal liver biochemistry. Although inflammatory markers are widely used in clinical assessment, their associations with hepatic biochemical abnormalities in hospitalized patients with COVID-19 remain incompletely defined. Methods: This retrospective cross-sectional secondary analysis included adults admitted with RT-PCR-confirmed COVID-19 at King Fahad Hospital Hofuf, Al-Ahsa, Saudi Arabia, from August through October 2020. Abnormal liver biochemistry was defined as alanine aminotransferase (ALT) >40 U/L, aspartate aminotransferase (AST) >40 U/L, or total bilirubin >21 μmol/L. C-reactive protein (CRP), ferritin, and D-dimer were evaluated as exposure variables. Group comparisons used nonparametric tests, correlations were assessed using Spearman coefficients, and marker-specific multivariable logistic regression models adjusted for age, sex, diabetes mellitus, hypertension, and chronic kidney disease. Results: Among 631 hospitalized patients (mean age 54.4 ± 14.4 years; 64.1% male), abnormal liver biochemistry was present in 59.2%. Ferritin levels were significantly higher in patients with abnormal than normal liver biochemistry ( Conclusions: Abnormal liver biochemistry was common in this cohort of hospitalized patients with COVID-19. Ferritin showed the most consistent association with hepatic biochemical abnormalities, supporting its potential value as a marker of inflammation-related liver involvement in this population. Prospective studies with standardized laboratory assessment are needed to confirm temporality and clinical utility.
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