Baseline aspartate aminotransferase activity is closely related to COVID-19 mortality: A bidirectional cohort study

 The coronavirus disease 2019 (COVID-19) outbreak has become a global public health pandemic, and many deaths occurred in a short period. It is possible for coronaviruses to cause hepatic injury, and the dying patient may complain about it. Aim of this study was to compare the liver function parameters, and demographic, clinical, and laboratory results between survivors and non-survivors of COVID-19.

 This was a retrospective-prospective cohort study conducted at Universal Hospital in Sudan. The Study included 80 cases of coronaviruse infected patients, of them 43 (53.7%) were female and 37 (46.3%) were male. A structured questionnaire was used to collect demographic, clinical, and results of liver function tests on the first day of admission. Patients were divided into survivors (treated and discharged) and non-survivors (died) groups, according to their outcomes. The analysis of the questionnaire was done using SPSS version 25.

 Out of the 80 coronaviruse infected patients, 35 (43.8%) were survivors while the remaining 45 (56.2%) were non-survivors. The results revealed a significant increase in the mean levels of AST (p. value= 0.001), ALT (p. value= 0.047), and decreased levels of Albumin (p. value= 0.009) in the Non-survivor group compared to the survivors' group. The regression analysis demonstrated a significant correlation between AST (p value =0.04) and albumin (p value=0.02) with COVID-19 death. In the Receiver Operation Curve (ROC) analysis, the Area Under the Curve (AUC) value of the AST was 0.70 (p=0.002) with sensitivity and specificity of 73% and 66%, respectively.

 The Study concluded that baseline AST level was significantly correlated with the mortality of COVID-19 patients.