TABLE 3.
Reported meta‐analysis of liver function/disease in COVID‐19
| Author (date of publication)Reference number | Included studies | Total number of patients | Liver disease (Yes/No) | Deranged LFT (yes/no) and % | Paediatric/pregnant patients included a (yes/no) | Impact of altered LFT or underlying CLD on outcome | Comments |
|---|---|---|---|---|---|---|---|
| Mantovani A et al (April 4th) 4 |
11 studies Chronic liver disease or deranged liver function tests. |
2034 |
3% (95% CI, 2‐4) had CLD. Main cause was hepatitis B/C. |
No | No | No |
No meta‐analysis of deranged liver function tests. Only Chinese patients. |
| Zheng Z et al (April 23rd) 5 | 13 studies | 3027 | No | No | No | Increased AST predicted severe disease. | Analysed risk factors for severe disease. |
| Parohan M et al (May 9th) 119 | 20 studies | 3428 | No | Yes. (mean differences between mild and severe cases) | No | Severely infected patients had higher AST, ALT and total bilirubin and hypoalbuminemia. | Only Chinese patients. |
| Sultan S et al (May 11th) 120 | 32 studies with liver abnormalities | 2711 | No | Yes. abnormal AST and ALT in 15% and bilirubin in 16.7% | No | No | Included both published and preprint studies. |
| Kukla M et al (11th May) 121 | SARS CoV‐2‐11 studies; SARS‐CoV‐1‐ 23. MERS‐ 9 studies | 2541 | No | No | No | No | Systematic review comparing liver function/histology in SARS‐CoV‐2 vs SARS‐CoV‐1 and MERS CoV. |
| Mao R et al (May 12th) 122 | 12 studies ith liver abnormalities. (4 paediatric studies) | 1267 | Pooled prevalence of digestive system comorbidities was 4% (95% CI 2‐5) | Abnormal LFT in 19% of adults. Increased ALT, AST, and total bilirubin in 18%, 21% and 6% |
Yes. GI symptoms similar to adults. Liver involvement in paediatric population not analysed. |
No | Mainly Chinese patients. Combined liver disease and other digestive comorbidities. |
| Wang H et al (May 12th) 123 | 16 studies reported liver function abnormalities | 3678 | 0.8%‐11% had chronic liver comorbidities | Abnormal LFT in 2.6%‐53%. | No | No | Mainly Chinese patients. Meta‐analysis of GI symptoms and Systematic review of liver function tests. |
| Oyelade T et al (May 15th) 124 | 22 studies (kidney and liver disease) | 5595 | 3% (95% CI; 2%‐3%) (CLD, Hepatitis B/C) | No | No | No | Systematic review −57.33% of liver disease patients had severe COVID‐19. |
| Youssef M et al (May 23rd) 125 |
20 studies Mild vs Severe |
3428 | No | No | No | Liver dysfunction associated with poor outcome. | Only Chinese patients. Lack of liver dysfunction definition. |
| Current meta‐analysis | 107 studies | 20 874 |
Yes 3.6% (95% CI, 2.5‐5.1) |
Yes, described each variable. | Yes | Yes. | Included worldwide data spanning 3 continents. Also described DILI. |
Abbreviations: DILI, drug induced liver injury; LFT, liver function test; MERS CoV, Middle East respiratory syndrome coronavirus; SARS‐CoV, severe acute respiratory syndrome coronavirus.
a
None of the previous studies included pregnant patients.