Comparison of liver elastography results in COVID-19 patients with and without increased liver enzymes

 The coronavirus disease 20149 (COVID-19) may be associated with the elevated liver enzymes including alanine aminotransferase (ALT) and aspartate aminotransferase (AST), in which the disease has been associated with more severity. Liver stiffness (LS) is associated with the increased liver enzymes. Liver elastography is a non-invasive technique that is used to evaluate LS. This study aimed to evaluate the functional status of liver and its relationship with liver elastography results in the patients with COVID-19.

 In this cross-sectional study, 90 patients with COVID-19, whose diagnosis was confirmed by polymerase chain reaction (PCR) test, were included. Levels of liver enzymes were measured and the patients underwent liver elastography. Liver size and interquartile range-median (IQR/M) of LS were also measured. Six months later, the patients underwent another liver elastography and measurement of liver enzymes.

 The frequency of fatty liver in the case group was significantly higher compared to the control group but no significant difference was observed in the frequency of liver fibrosis between two groups. In patients with COVID-19, the LS and IQR/M values at the beginning and six months after recovery were significantly higher in the group with the increased liver enzymes (case) compared to the group without the increased enzymes (control). P value was 0.001.

 The use of elastography to evaluate LS in the patients with COVID-19 can be significantly effective in assessing the status of liver damage and inflammation of liver tissue. Since elastography is an inexpensive and non-invasive available tool, it can be used mainly in most medical centers.