Hepatic response in COVID-19

Abstract

Introduction: World is facing a pandemic by novel coronavirus termed as COVID-19. Patients shows symptoms of fever, respiratory discomfort and myalgia along with liver injury and GI symptoms such as abdominal pain, nausea, vomiting and diarrhoea. GI symptoms were also common during the previous outbreak of coronavirus family. Hepatic injury was assessed with abnormal serum levels of alanine aminotransferase, aspartate aminotransferase, total bilirubin, concentration of cytokine and acute phase protein. Material and Methods: The present study was carried out in Govt. Medical College, Jalaun at Department of Biochemistry. The diagnosis of COVID-19 was made by at least one positive SARS-CoV-2 (RDRP) or Beta CoV (E-gene) or COVID-19 (E-gene/Orf1A) Truenat test performed on nasopharyngeal swab samples. 10 ml of fasting venous blood was collected from the antecubital vein in a plain, fluoride and EDTA vacutainers. The blood sample was centrifuged and stored at 40 C for biochemical and immunological investigations. The study group consisted of four groups Normal (Group I) n=50 and COVID-19 positive patients (Total) (Group II) in two groups, Stable Patients (Group III) n=25 and Unstable patients (Group IV) n=25 are critically ill patients requiring ICU admission or intensive support of either sex aged between 40-65 years. The diagnosis of Liver disease was done by ultrasonographic examination of liver. Serum levels of ALT, AST, Total Bilirubin, Cytokine (IL-6), malondialdehyde (MDA), reduced glutathione (GSH) and acute phase protein (CRP) were estimated. Results: Mean value of ALT 20.10 ± 5.60, 110.34 ± 48.02, 158.6 ± 51.24* and 200.61± 58.35*, AST 28.50 ± 7.50, 104.20± 38.55*, 144.35 ± 46.60* and 193.15 ± 52.43* T.Bil 0.80 ± 0.15, 167.5 ± 84.13*, 143.3 ± 47.81* and 220.37 ± 119.73** Concentration of cytokine IL-6 9.24±1.20, 14.14±1.50*, 15.34±1.40* and 36.76±11.56** acute phase protein CRP 0.90±1.10 1.96±0.50*, 1.99±0.54* and 2.18±0.90 was significantly elevated in Group II, III, IV as compared to Group I. Conclusion: Results of the present study indicates that the levels of ALT, AST, Total Bilirubin, CRP and IL-6 increased in parallel with the progression of covid-19 positive patients which indicates COVID-19 might end with hepatic injury.