Gamma‐Glutamyltransferase Elevation Is Frequent in Patients With COVID‐19: A Clinical Epidemiologic Study

A newly identified coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), which causes the infectious coronavirus disease 2019 (COVID‐19), emerged in December 2019 in Wuhan, Hubei Province, China, and now poses a major threat to global public health. Previous studies have observed highly variable alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels in patients with COVID‐19. However, circulating levels of the cholangiocyte injury biomarker gamma‐glutamyltransferase (GGT) have yet to be reported in the existing COVID‐19 case studies. Herein, we describe the relationship between GGT levels and clinical and biochemical characteristics of patients with COVID‐19. Our study is a retrospective case series of 98 consecutive hospitalized patients with confirmed COVID‐19 at Wenzhou Central Hospital in Wenzhou, China, from January 17 to February 5, 2020. Clinical data were collected using a standardized case report form. Diagnosis of COVID‐19 was assessed by symptomatology, reverse‐transcription polymerase chain reaction (RT‐PCR), and computed tomography scan. The medical records of patients were analyzed by the research team. Of the 98 patients evaluated, elevated GGT levels were observed in 32.7%; increased C‐reactive protein (CRP) and elevated ALT and AST levels were observed in 22.5%, 13.3%, and 20.4%, respectively; and elevated alkaline phosphatase (ALP) and triglycerides (TGs) were found in 2% and 21.4%, respectively. Initially, in the 82 patients without chronic liver disease and alcohol history, age older than 40 years (P = 0.027); male sex (P = 0.0145); elevated CRP (P = 0.0366), ALT (P < 0.0001), and ALP (P = 0.0003); and increased TGs (P = 0.0002) were found to be associated with elevated GGT levels. Elevated GGT (P = 0.0086) and CRP (P = 0.0162) levels had a longer length of hospital stay. Conclusion: A sizable number of patients with COVID‐19 infection have elevated serum GGT levels. This elevation supports involvement of the liver in persons with COVID‐19.