Transaminiases and their association with disease severity and mortality in patients with Corona Virus Disease (COVID-19) in a tertiary hospital in the Philippines

Coronavirus 2019 (COVID-19) progressed into a pandemic, reaching the province of Ilocos Norte, Philippines, four (4) months after its outbreak from China. Although it presents mostly with respiratory symptoms, multiple extrapulmonary organ dysfunctions have been reported. This study aims to describe the role of COVID-19 virus on Alanine Transaminase (ALT) and Aspartate Transaminase (AST) and to correlate the outcome with disease severity and mortality in patients confirmed with COVID-19. This is a retrospective study of 251 adult COVID-19 patients. Transaminases (ALT and AST) and COVID-19 disease severity and mortality were analyzed via review of medical records and subjected to Pearsons, Spearman and Point Bi-Serial Correlations together with Chi-square Fishers Exact Test. Among the 251 patients, 28.29% had moderate illness, 35.06% severe illness and 36.65% with critical illness. Normal ALT was seen in the moderate illness group, mild liver injury in the severe and critical illness group with p=0.028. Mild liver injury in AST was seen in all COVID-19 groups with p=0.000. Of the 81 (32.27%) patients who expired, all coming from the critical illness group, had a mean age of 68 years old, male gender, all had elevated ALT and AST with 53.1% and 81.5% respectively. Only AST elevation showed significant association with mortality (p=0.000). Liver involvement was observed in this study. Increasing age, liver injury (elevated ALT and AST) and length of hospital days were related to illness severity. However, elevated AST, illness severity together with increase in age and length of hospital days were associated with mortality.