{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T11:48:48Z","timestamp":1784029728880,"version":"3.55.0"},"reference-count":53,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,6,9]],"date-time":"2021-06-09T00:00:00Z","timestamp":1623196800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007547","name":"Fourth Military Medical University","doi-asserted-by":"publisher","award":["XJGX15Y0"],"award-info":[{"award-number":["XJGX15Y0"]}],"id":[{"id":"10.13039\/501100007547","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007547","name":"Fourth Military Medical University","doi-asserted-by":"publisher","award":["XJZT18H02"],"award-info":[{"award-number":["XJZT18H02"]}],"id":[{"id":"10.13039\/501100007547","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007547","name":"Fourth Military Medical University","doi-asserted-by":"publisher","award":["XJZT19ML15"],"award-info":[{"award-number":["XJZT19ML15"]}],"id":[{"id":"10.13039\/501100007547","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002858","name":"China Postdoctoral Science Foundation","doi-asserted-by":"publisher","award":["2019TQ0134"],"award-info":[{"award-number":["2019TQ0134"]}],"id":[{"id":"10.13039\/501100002858","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p><jats:bold>Background and Aim:<\/jats:bold> The impact of liver function test (LFTs) abnormality on adverse clinical outcomes in coronavirus disease 2019 (COVID-19) patients remains controversial. The aim of this study was to assess the impact of abnormal LFTs on clinical outcomes in a large cohort of hospitalized patients with COVID-19.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> We retrospectively collected data on 2,912 consecutive patients with COVID-19 who were admitted to a makeshift hospital in China between 5 February and 23 March 2020. The association between LFTs abnormalities (baseline and peak values) and clinical outcomes was measured by using Cox regression models.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> On admission 1,414 patients (48.6%) had abnormal LFTs, with alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), alkaline phosphatase (ALP), and gamma-glutamyltransferase (GGT) elevation in 662 (22.7%), 221 (7.6%), 52 (1.8%), 135 (4.6%), and 536 (18.5%) patients, respectively, and hypoalbuminemia in 737 (25.3%) patients. During a median 13 (IQR: 8\u201319) days of hospitalization, 61 patients (2.1%) died, 106 patients (3.6%) admitted to intensive care unit (ICU), and 75 patients (2.6%) required mechanical ventilation. After adjustment for confounders, baseline abnormal LFTs were independently associated with increased risks of mortality (adjusted HR 3.66, 95%CI 1.64\u20138.19, <jats:italic>p<\/jats:italic> = 0.002), ICU admission (adjusted HR 3.12 95%CI 1.86\u20135.23, <jats:italic>p<\/jats:italic> &amp;lt; 0.001), and mechanical ventilation (adjusted HR 3.00, 95%CI 1.63\u20135.52, <jats:italic>p<\/jats:italic> &amp;lt; 0.001), which was homogeneous across the severity of COVID-19 infection. Among the parameters of LTFs, the associations with the outcomes were more pronounced for AST and albumin abnormality. In contrast, ALT elevation was not significantly associated with those outcomes. Similar results were observed for peak values of LFTs during hospitalization.<\/jats:p><jats:p><jats:bold>Conclusions:<\/jats:bold> Abnormality of AST, albumin, TBIL, ALP, and GGT but not ALT were independently associated with adverse outcomes.<\/jats:p>","DOI":"10.3389\/fmed.2021.639855","type":"journal-article","created":{"date-parts":[[2021,6,9]],"date-time":"2021-06-09T05:41:55Z","timestamp":1623217315000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":18,"title":["Abnormal Liver Function Tests Were Associated With Adverse Clinical Outcomes: An Observational Cohort Study of 2,912 Patients With COVID-19"],"prefix":"10.3389","volume":"8","author":[{"given":"Yong","family":"Lv","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaodi","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingpu","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengfei","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaodong","family":"Feng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yao","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yipeng","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liyu","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guohong","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huahong","family":"Xie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,6,9]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"727","DOI":"10.1056\/NEJMoa2001017","article-title":"A novel coronavirus from patients with pneumonia in China, 2019","volume":"382","author":"Zhu","year":"2020","journal-title":"N Engl J Med."},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00028-20","article-title":"Coronavirus disease 2019-COVID-19","author":"Dhama","year":"2020","journal-title":"Clin Microbiol Rev."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1455","DOI":"10.1152\/physrev.00020.2020","article-title":"SARS-CoV-2 and COVID-19: from the bench to the bedside","volume":"100","author":"Romagnoli","year":"2020","journal-title":"Physiol Rev."},{"key":"B4","doi-asserted-by":"publisher","first-page":"1239","DOI":"10.1001\/jama.2020.2648","article-title":"Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention","volume":"323","author":"Wu","year":"2020","journal-title":"JAMA."},{"key":"B5","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.physrep.2020.07.005","article-title":"COVID-19 and SARS-CoV-2. 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