Haematological Dysfunction as a Predictor of Hepatic Alterations in COVID-19 Patients: A Retrospective Cohort Study

Abstract

Background: COVID-19 is a multisystemic disease affecting various organs, including the haematological and hepatic systems. Identifying correlations between haematological dysfunction and hepatic alterations may provide valuable insight into predicting disease severity and outcomes in COVID-19 patients.

Aim: This study aimed to investigate whether haematological abnormalities, particularly elevated white blood cell (WBC) counts and inflammatory markers, can serve as predictors of hepatic dysfunction in COVID-19 patients.

Methods: A retrospective cohort study was conducted on 442 hospitalized COVID-19 patients at a tertiary care hospital in Saudi Arabia. Demographic, clinical, and laboratory data were collected, including haematological markers (haemoglobin, WBC, ferritin) and liver function tests (ALT, AST, albumin). Associations between haematological findings and hepatic dysfunction were analysed using chi-square tests, t-tests, and multivariate logistic regression to identify independent predictors of liver dysfunction.

Results: Elevated WBC counts (p=0.027) and ferritin levels (p=0.042) were significantly correlated with higher ALT and AST levels, indicating hepatic dysfunction. Low haemoglobin levels were associated with lower albumin levels (p=0.009) and prolonged prothrombin time (p=0.016), though they were not independent predictors of liver enzyme elevations. Multivariate analysis showed that elevated WBC (AOR=1.095, p=0.027) and ferritin (AOR=1.253, p=0.042) were significant predictors of hepatic dysfunction.

Conclusion: Haematological dysfunction, particularly elevated WBC counts and ferritin levels, is a significant predictor of hepatic alterations in COVID-19 patients. Monitoring these markers can help identify patients at higher risk of liver injury, potentially guiding clinical management and improving outcomes.