Prevalence of acute liver injury and hypertransaminemia in patients with COVID-19: a protocol for a systematic review.

Prevalence of acute liver injury and hypertransaminemia in patients with COVID-19: a protocol for a systematic review.

Publication date: Jul 07, 2020

COVID-19 has spread rapidly in China and around the world. Published studies have revealed that some patients with COVID-19 had abnormal liver function in laboratory tests. However, the results were inconsistent and the analysis of epidemiological data stratified by the severity of COVID-19 was not available in previous meta-analyses. Furthermore, these meta-analyses were suspected of overestimating the incidence of liver injury in patients with COVID-19 because some studies considered transaminase elevation as liver injury, which might partially result from cardiac and muscle injury. This systematic review aims to enrol published literatures related to COVID-19 without language restriction, analyse the data based on the severity of the COVID-19 and explore the impact of varied definitions of liver injury on the incidence of liver injury.

We have conducted a preliminary search on PubMed and Excerpta Medica Database on 13 April 2020, for the studies published after December 2019 on the prevalence of acute liver injury and hypertransaminemia in patients with COVID-19. Two reviewers will independently screen studies, extract data and assess the risk of bias. We will estimate the pooled incidence of hypertransaminemia and acute liver injury in patients with COVID-19 by using the random-effects model. The I test will be used to identify the extent of heterogeneity. Publication bias will be assessed by funnel plot and performing the Begg’s and Egger’s test if adequate studies are available. We will perform a risk of bias assessment using the Joanna Briggs Institute’s critical appraisal checklist.

Since this study will be based on the published data, it does not require ethical approval. The final results of this study will be published in a peer-reviewed journal.


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Concepts Keywords
Cardiac Muscle Epidemiology
China Elevated transaminases
Epidemiological Meta-analysis
Excerpta Medica Database Clinical medicine
Heterogeneity Hepatology
Incidence Systematic review
Liver Medicine
Protocol Medical specialties
PubMed Muscle injury
Random Effects Model Preliminary search
Systematic Review Liver
Transaminase Funnel plot
Sports injury
19 protocol


Type Source Name
disease MESH infections
drug DRUGBANK Coenzyme M
drug DRUGBANK L-Alanine
disease MESH pneumonia
disease MESH risk factors
drug DRUGBANK Alkaline Phosphatase
drug DRUGBANK Trimebutine

Original Article

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