The Liver & COVID-19

Prof. Lim Seng Gee

National University Health System, Singapore

Key concerns during COVID-19 for impact on the liver

Does COVID-19 affect the liver, and how bad is it?
How does COVID-19 affect those with liver disease?

Frequency of Abnormal LFTS during COVID

3381 patients tested in 3 US Hospitals of which 2273 patients tested positive

COVID can cause abnormal LFTS during the course of illness However these are usually mild

Phipps, Hepatology 2020 May 30 (in press)

Factors associated with ALT>5x ULN

Severe COVID is associated with high levels of abnormal ALT

n=145 out of 2273 patients

Phipps, Hepatology 2020 May 30 (in press)

Deaths in patients with Chronic Liver Disease who have COVID-19

152 consecutive patients with CLD and COVID-19 from a Disease Registry

Death in those with liver disease and COVID is related to cirrhosis status

Moon, J Hepatol May 2020 (in press)

Risk factors associated with mortality in CLD

Those with the worse liver function (CTP C cirrhosis) have the highest risk of death

Moon, J Hepatol May 2020 (in press)

Learning Points

Abnormal LFTs is common in COVID-19 but is usually mild

More severely abnormal LFTs occurs with more severe COVID-19

Those with liver disease have increased mortality usually related to more advanced liver disease especially CTP C cirrhosis

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