Dynamics variations of liver function monitoring the risk of in-hospital mortality
The temporal patterns of liver biochemistry parameters over time from illness onset differed by different survival outcomes of COVID-19 patients (figure 4). In general, the levels of ALT, AST, and TBIL varied in a wider range over time in the non-survivors than in the survivors. Although no pronounced elevation of ALT levels was observed especially at the time of admission, there was a smooth decrease over time in the survivors compared to a sharp elevation in the fourth week in the non-survivors. AST and TBIL levels at the time of admission tended to be higher in the non-survivors and showed sharp elevation in the fourth and sixth weeks or continuous elevation until the fifth week, respectively,contrast with almost no variation over time in survivors (figure 4). The peak of ALT, AST, and TBIL happened in the fourth, sixth and fifth week from illness onset, respectively. Additional liver biochemistry markers such as GGT, direct bilirubin, and albumin also presented different time-varying tendency in the non-survivors from that of survivors (supplementary figure 4).