Long-term Hepatic Sequelae of Mild Coronavirus Disease 2019: Elevated Liver Enzymes at 10-month Follow-up

Abstract BACKGROUND: Long coronavirus disease 2019 (COVID-19) can affect multiple organ systems, with its long-term impact on liver function in mild cases remaining unclear. This study aimed to evaluate hematological and biochemical parameters, particularly liver function, in middle-aged individuals 10 months after mild COVID-19 infection, with a focus on informing preventive, diagnostic, and treatment strategies. METHODS: We conducted a case–control study involving 300 age- and gender-matched participants who had recovered from mild COVID-19. Clinical history was obtained to identify persistent symptoms and classify participants into long COVID-19 and control groups. Hematological indices and liver function tests were compared between groups. RESULTS: At 10 months postinfection, 59% of participants reported long COVID-19 symptoms, predominantly neuropsychiatric, musculoskeletal, and respiratory complaints. Individuals with long COVID-19 exhibited significantly lower hemoglobin, red blood cell, and white blood cell counts compared to controls ( P < 0.05). Liver enzymes, including alanine aminotransferase, alkaline phosphatase, and gamma-glutamyl transferase, were significantly elevated in the long COVID-19 group ( P < 0.05), indicating persistent hepatic involvement. CONCLUSION: A substantial proportion of middle-aged individuals with mild COVID-19 experience persistent symptoms and biochemical alterations, particularly in liver function, even 10 months after infection. These findings highlight the need for preventive strategies such as regular monitoring of liver function in post-COVID-19 patients, early diagnostic screening for hepatic and hematological abnormalities, and timely intervention to manage and mitigate long-term complications. Comprehensive follow-up and targeted treatment protocols are essential to reduce the burden of long COVID-19 and improve patient outcomes.