Background: Abnormal liver enzymes have been reported in COVID-19 patients with severe presentation. However, limited studies exist in our region regarding the impact of COVID-19 on the liver’s function, thus, we aimed to investigate liver enzymes changes and association with prognosis and outcome in hospitalized COVID-19 patients in Jordan.

Methods: This retrospective cohort’s study included 359 COVID-19 positive patients who were admitted to Ministry of Health hospitals all around Jordan during the period of the second pandemic wave of COVID-19 in Jordan. Data such as liver enzymes, patients demographics and outcomes were collected and statistically analysed.  

Results: Approximately 39.55% of patients had elevated liver enzymes, and 5.85% were elevated more than twice the upper limit of normal. Among these patients, 40.8% had both AST and ALT elevation, 52.1% had AST elevation alone, and 7.0% had ALT elevation alone. Factors associated with worse prognosis and outcome were older age, males and comorbid autoimmune conditions. The peak and at-discharge values of AST and ALT showed significant differences.

Conclusion: Liver enzyme abnormality is common among COVID-19 patients with AST being the most common abnormality. AST and ALT elevation can be associated with longer hospital stay, older age and males.