Liver complications are common and are associated with more severe disease in patients with COVID-19, a review shows.

European researchers evaluated the hepatic manifestations and complications of COVID-19 in their systematic review of 19 retrospective cohort studies (14 from China and five from the USA), including more than 15,000 patients with the infection..

Pre-existing chronic liver disease appeared to be present in only 2% of patients, including cirrhosis (0.4%), hepatitis B (0.9%), and hepatitis C (0.3%), the researchers reported in their letter to the Journal of Infection.

On admission, 27% of patients had elevated alanine aminotransferase (ALT), 37% had elevated aspartate aminotransferase (AST), 46% had low albumin and 18% had elevated total bilirubin.