Conference 2021 Video


Project title

Liver function test abnormality as a prognostic factor of COVID-19 severity
: A literature review


Authors and Affiliations

Adriana Viola Miranda1, Cosmas Rinaldi A. Lesmana1,2

1. Faculty of Medicine, University of Indonesia
2. Hepatobiliary Division, Department of Internal Medicine, Dr. Cipto Mangunkusumo National General Hospital




Currently, the prevalence of Coronavirus disease (COVID-19) cases and its mortality rate are still increasing. Recent studies have reported the short timeframe of COVID-19 severity progression, thus emphasizing the need for a method that can predict its occurrence adequately. This review aims to evaluate the clinical significance of liver function test abnormality as a prognostic factor of COVID-19 severity.


Literature search in five databases, PubMed, Cochrane, Scopus, MEDLINE and SpringerLink was conducted in May 2020. Article selection was conducted based on PICO and eligibility criteria. Critical appraisal of selected articles was conducted using CEBM (Centre for Evidence-Based Medicine) worksheet 2018 from Oxford University, United Kingdom.


Abnormalities of liver function tests, including alanine transferase (ALT), aspartate transaminase (AST), total bilirubin level, albumin, alkaline phosphatase (ALP) and gamma-glutamyl transferase (GGT), can be utilized as a prognostic factor of COVID-19 severity. However, to date, there is no consensus regarding the specific cutoff value of the prognostic factors. The studies report that these abnormalities are due to existing chronic liver diseases and/or acute liver injury due to COVID-19. These abnormalities also show the importance of adequate nutrition monitoring and limiting hepatotoxic drug consumption in COVID-19 patients, since nutrition and certain drugs are known to affect liver functions.


Liver function tests have the potential to be the prognostic factors of COVID-19. Further research is needed to determine the cutoff value of the prognostic factors.