key: cord-1027360-tz07j57w
authors: hayat, Ahmad
title: Letter to the editor: Clinical Features of Patients Infected With Coronavirus Disease 2019 With Elevated Liver Biochemistries: A Multicenter, Retrospective Study
date: 2022-04-05
journal: Hepatology
DOI: 10.1002/hep.32506
sha: 4628a6787c5013ac1d6f0140f55e9b93177c3e6e
doc_id: 1027360
cord_uid: tz07j57w

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limitations indicated in the study, but some contrasting approaches may improve and strengthen the findings of the study.

Firstly, in their study, authors included COVID-19 patients diagnosed through real-time reversetranscription polymerase chain reaction (RT-PCR) assay of pharyngeal swab specimens, which only confirms the COVID infection but underestimates the severity of infection in each individual.

For illustration 2020 study included COVID diagnosed patients through RT-PCR but also evaluated chest radiographs of each individual and categorized it into seven stages on the basis of severity of chest radiographs of each individual, which might affect the study findings. 2 Second, the author should have been more concerned about the patient's treatment prior to admission, as well as antivirals and antibiotics. For example, a study conducted in 2021 detailed some antivirals, corticosteroids and antibiotics, including antimalarial hydroxychloroquine and the antibody to IL-6 receptors, tocilizumab, as a variable for the patient. As established, both drugs contribute to hepatic toxicity and can result in the elevation of liver enzymes. 3 Since this study is of retrospective nature, some major concerns arise because of the notable risk of bias in the patient's history and documentation, resulting in unreasonable laboratory findings. As an illustration, a 2020 study found that patients with COVID-19 often had reduced levels of albumin, followed by fluctuations in gamma-glutamyl transferase and aminotransferase. However, the author reported normal levels of albumin among most participants. 4 Finally, the author should have elaborated on various liver pathologies in patients with coronaviruses, which have resulted in serious consequences. Similarly, a study conducted in

Clinical Features of Patients Infected With Coronavirus Disease

With Elevated Liver Biochemistries: A Multicenter, Retrospective Study

SARS-CoV-2 infection of the liver directly contributes to hepatic impairment in patients with COVID-19

Abnormal Liver Biochemistry Tests and Acute Liver Injury in COVID-19 Patients: Current Evidence and Potential Pathogenesis. Diseases

Coronavirus disease (COVID-19) and the liver: a comprehensive systematic review and meta-analysis

Accepted Article