Skip to main content Skip to main navigation menu Skip to site footer

Liver function characteristics of COVID-19 patients with obesity at Dr. Soetomo Hospital: case series

  • Erwin Maulana Farmanda Putra ,
  • Ummi Maimunah ,

Abstract

Background: Coronavirus disease 2019 (COVID-19) patients with obesity are more susceptible to liver injury. There is currently no published overview regarding COVID-19 patients with liver injury in Indonesia. Our study reported 7 cases of obese COVID-19 patients with an increase of serum glutamic oxaloacetic transaminase (SGOT) and serum glutamic pyruvic transaminase (SGPT), followed by 5 of them developing severe symptoms of COVID-19 in isolation room of Dr. Soetomo Hospital Surabaya within June-December 2020.

Case Presentation: A total of 7 COVID-19 patients, by the average age 46.2±15.5 years, were obese. The mean body mass index (BMI) was 36,3±3,4 kg/m2. Five of them experienced serious symptoms. There were 3 patients (patient no. 2, 4, 7) who had normal SGOT level, while the rest had an increased SGOT level for <2x upper limit of normal (ULN) at admission. During treatment, SGOT level increased in 5 patients for 1-<3x ULN and normal in the rest of them (patient no. 2, 4). Meanwhile, the normal SGPT levels were shown in 3 patients (patient no. 2, 4, 7) and increased in 4 others at admission for 1-<4x ULN. All of them tended to have an increased SGPT level during treatment for 1-<5x ULN. However, since the increase of SGOT and/or SGPT for >3x ULN is defined as liver injury, it happened in 2 patients that occur since admission (patient no. 3) and during treatment (patient no. 5).

Conclusion: Obesity may impede the recovery of COVID-19 and manifest in the deterioration of liver function.

References

  1. Fahriani M, Ilmawan M, Fajar JK, Maliga HA, Frediansyah A, Masyeni S, et al. Persistence of long COVID symptoms in COVID-19 survivors worldwide and its potential pathogenesis - A systematic review and meta-analysis. Narra J [Internet]. 2021;1(2). Available from: http://dx.doi.org/10.52225/narraj.v1i2.36
  2. Fajar JK, Ilmawan M, Mamada S, Mutiawati E, Husnah M, Yusuf H, et al. Global prevalence of persistent neuromuscular symptoms and the possible pathomechanisms in COVID-19 recovered individuals: A systematic review and meta-analysis. Narra J [Internet]. 2021;1(3). Available from: http://dx.doi.org/10.52225/narra.v1i3.48
  3. Lusida MAP, Salamah S, Jonatan M, Wiyogo IO, Asyari CH, Ali ND, et al. Prevalence of and risk factors for depression, anxiety, and stress in non-hospitalized asymptomatic and mild COVID-19 patients in East Java province, Indonesia. PLoS One [Internet]. 2022 Jul 7;17(7):e0270966–e0270966. Available from: https://pubmed.ncbi.nlm.nih.gov/35797394
  4. Fahriani M, Anwar S, Yufika A, Bakhtiar B, Wardani E, Winardi W, et al. Disruption of childhood vaccination during the COVID-19 pandemic in Indonesia. Narra J [Internet]. 2021;1(1). Available from: http://dx.doi.org/10.52225/narraj.v1i1.7
  5. Wagner AL, Rajamoorthy Y, Taib NM. Impact of economic disruptions and disease experiences on COVID-19 vaccination uptake in Asia: A study in Malaysia. Narra J [Internet]. 2021;1(2). Available from: http://dx.doi.org/10.52225/narraj.v1i2.42
  6. Sarengat R, Islam MS, Ardhi MS. Correlation of neutrophil-to-lymphocyte ratio and clinical outcome of acute thrombotic stroke in patients with COVID-19. Narra J [Internet]. 2021;1(3). Available from: http://dx.doi.org/10.52225/narra.v1i3.50
  7. Dinia F, Trisnantoro L, Helmi M. Managing Human Resources for Surge Capacity in Referral Hospitals Based on WHO Hospital Readiness Checklist for Covid-19. Folia Medica Indones [Internet]. 2022;58(2):141–9. Available from: http://dx.doi.org/10.20473/fmi.v58i2.32579
  8. Sutadji JC, Widodo ADW, Indiastuti DN. Mortality Comparison of Using Anti Interleukin-6 Therapy and Using Standard Treatment in Severe Covid-19. Folia Medica Indones [Internet]. 2021;57(2):158. Available from: http://dx.doi.org/10.20473/fmi.v57i2.21929
  9. Sharun K, Tiwari R, Iqbal Yatoo M, Patel SK, Natesan S, Dhama J, et al. Antibody-based immunotherapeutics and use of convalescent plasma to counter COVID-19: advances and prospects. Expert Opin Biol Ther [Internet]. 2020;20(9):1033–46. Available from: http://dx.doi.org/10.1080/14712598.2020.1796963
  10. Triyono EA, Seipalla F, Djaja N, Akbas AMI, Ar-Rahmah KA, Budiono PS, et al. Clinical characteristics of patients with COVID-19 admitted to the COVID-19 Emergency Field Hospital of Bangkalan, Indonesia. F1000Research [Internet]. 2022;11:414. Available from: http://dx.doi.org/10.12688/f1000research.110716.2
  11. Cai Q, Chen F, Wang T, Luo F, Liu X, Wu Q, et al. Obesity and COVID-19 Severity in a Designated Hospital in Shenzhen, China. Diabetes Care [Internet]. 2020;43(7):1392–8. Available from: http://dx.doi.org/10.2337/dc20-0576
  12. Harapan H, Fajar JK, Supriono S, Soegiarto G, Wulandari L, Seratin F, et al. The prevalence, predictors and outcomes of acute liver injury among patients with COVID-19: A systematic review and meta-analysis. Rev Med Virol [Internet]. 2021/10/13. 2022 May;32(3):e2304–e2304. Available from: https://pubmed.ncbi.nlm.nih.gov/34643006
  13. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet (London, England) [Internet]. 2020/01/30. 2020 Feb 15;395(10223):507–13. Available from: https://pubmed.ncbi.nlm.nih.gov/32007143
  14. Hu X, Pan X, Zhou W, Gu X, Shen F, Yang B, et al. Clinical epidemiological analyses of overweight/obesity and abnormal liver function contributing to prolonged hospitalization in patients infected with COVID-19. Int J Obes (Lond) [Internet]. 2020/06/22. 2020 Aug;44(8):1784–9. Available from: https://pubmed.ncbi.nlm.nih.gov/32572128
  15. Zheng KI, Gao F, Wang XB, Sun QF, Pan KH, Wang TY, et al. Letter to the Editor: Obesity as a risk factor for greater severity of COVID-19 in patients with metabolic associated fatty liver disease. Metabolism [Internet]. 2020/04/19. 2020 Jul;108:154244. Available from: https://pubmed.ncbi.nlm.nih.gov/32320741
  16. Liu L, Qu H, Li JJ, Yang YW, Zeng QX, Gong YW, et al. Effectiveness of methylprednisolone therapy in patients with a high-risk common type of COVID-19 pneumonia: a retrospective cohort study. Clin Exp Med [Internet]. 2021/10/22. 2022 Aug;22(3):487–97. Available from: https://pubmed.ncbi.nlm.nih.gov/34677701
  17. Apicella M, Campopiano MC, Mantuano M, Mazoni L, Coppelli A, Del Prato S. COVID-19 in people with diabetes: understanding the reasons for worse outcomes. lancet Diabetes Endocrinol [Internet]. 2020/07/17. 2020 Sep;8(9):782–92. Available from: https://pubmed.ncbi.nlm.nih.gov/32687793
  18. Petrakis D, Margină D, Tsarouhas K, Tekos F, Stan M, Nikitovic D, et al. Obesity ‑ a risk factor for increased COVID‑19 prevalence, severity and lethality (Review). Mol Med Rep [Internet]. 2020/05/05. 2020 Jul;22(1):9–19. Available from: https://pubmed.ncbi.nlm.nih.gov/32377709
  19. Zahra Z, Ramadhani CT, Mamfaluti T, Pamungkas SR, Firdausa S. Association between depression and HbA1c levels in the elderly population with type 2 diabetes mellitus during COVID-19 pandemic. Narra J [Internet]. 2022;2(1). Available from: http://dx.doi.org/10.52225/narra.v2i1.51
  20. Bangash MN, Patel J, Parekh D. COVID-19 and the liver: little cause for concern. lancet Gastroenterol Hepatol [Internet]. 2020/03/20. 2020 Jun;5(6):529–30. Available from: https://pubmed.ncbi.nlm.nih.gov/32203680
  21. Xu L, Liu J, Lu M, Yang D, Zheng X. Liver injury during highly pathogenic human coronavirus infections. Liver Int [Internet]. 2020/03/30. 2020 May;40(5):998–1004. Available from: https://pubmed.ncbi.nlm.nih.gov/32170806
  22. Bansal R, Gubbi S, Muniyappa R. Metabolic Syndrome and COVID 19: Endocrine-Immune-Vascular Interactions Shapes Clinical Course. Endocrinology [Internet]. 2020 Oct 1;161(10):bqaa112. Available from: https://pubmed.ncbi.nlm.nih.gov/32603424
  23. Ritter A, Kreis NN, Louwen F, Yuan J. Obesity and COVID-19: Molecular Mechanisms Linking Both Pandemics. Int J Mol Sci [Internet]. 2020 Aug 12;21(16):5793. Available from: https://pubmed.ncbi.nlm.nih.gov/32806722
  24. Cardoso FS, Pereira R, Germano N. Liver injury in critically ill patients with COVID-19: a case series. Crit Care [Internet]. 2020 May 5;24(1):190. Available from: https://pubmed.ncbi.nlm.nih.gov/32366282
  25. Cai Q, Huang D, Yu H, Zhu Z, Xia Z, Su Y, et al. COVID-19: Abnormal liver function tests. J Hepatol [Internet]. 2020/04/13. 2020 Sep;73(3):566–74. Available from: https://pubmed.ncbi.nlm.nih.gov/32298767
  26. Ji D, Qin E, Xu J, Zhang D, Cheng G, Wang Y, et al. Non-alcoholic fatty liver diseases in patients with COVID-19: A retrospective study. J Hepatol [Internet]. 2020/04/08. 2020 Aug;73(2):451–3. Available from: https://pubmed.ncbi.nlm.nih.gov/32278005
  27. Eslam M, George J. Reply to: correspondence regarding “A new definition for metabolic dysfunction-associated fatty liver disease: An international expert consensus statement.” J Hepatol [Internet]. 2020;73(6):1575. Available from: http://dx.doi.org/10.1016/j.jhep.2020.07.045
  28. Sharma P, Kumar A. Metabolic dysfunction associated fatty liver disease increases risk of severe Covid-19. Diabetes Metab Syndr [Internet]. 2020/06/10. 2020;14(5):825–7. Available from: https://pubmed.ncbi.nlm.nih.gov/32540736
  29. van der Poorten D, Milner KL, Hui J, Hodge A, Trenell MI, Kench JG, et al. Visceral fat: A key mediator of steatohepatitis in metabolic liver disease. Hepatology [Internet]. 2008;48(2):449–57. Available from: http://dx.doi.org/10.1002/hep.22350
  30. Tang H, Zhou L, Li X, Kinlaw AC, Yang JY, Moon AM, et al. Drug-induced liver injury associated with lopinavir-ritonavir in patients with COVID-19: a disproportionality analysis of U.S. food and drug administration adverse event reporting system (FAERS) data. Int J Clin Pharm [Internet]. 2021/07/30. 2021 Aug;43(4):1116–22. Available from: https://pubmed.ncbi.nlm.nih.gov/34328585
  31. Mostafa EMA, Tawfik AM, Abd-Elrahman KM. Egyptian perspectives on potential risk of paracetamol/acetaminophen-induced toxicities: Lessons learnt during COVID-19 pandemic. Toxicol reports [Internet]. 2022/03/29. 2022;9:541–8. Available from: https://pubmed.ncbi.nlm.nih.gov/35371923
  32. Cao B, Wang Y, Wen D. A Trial of Lopinavir–Ritonavir in Covid-19. N Engl J Med [Internet]. 2020;382(21):e68. Available from: http://dx.doi.org/10.1056/nejmc2008043
  33. Zhao L, Pickering G. Paracetamol metabolism and related genetic differences. Drug Metab Rev [Internet]. 2010;43(1):41–52. Available from: http://dx.doi.org/10.3109/03602532.2010.527984

How to Cite

Putra, E. M. F., & Ummi Maimunah. (2022). Liver function characteristics of COVID-19 patients with obesity at Dr. Soetomo Hospital: case series. Bali Medical Journal, 11(3), 1795–1799. https://doi.org/10.15562/bmj.v11i3.3727

HTML
2

Total
3

Share

Search Panel

Erwin Maulana Farmanda Putra
Google Scholar
Pubmed
BMJ Journal


Ummi Maimunah
Google Scholar
Pubmed
BMJ Journal