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Abstract SUMMARY T he SARS-COV2 is a large (27–32 kb) positive-strand RNA virus belonging to the Orthocoronavirinae subfamily, and the angiotensin-converting enzyme 2 (ACE2) receptor is thought to be the main receptor for viral spike protein and important for infectivity. To evaluate liver affection in children diagnosed with COVID-19, to assess the effectiveness of glutamate dehydrogenase (GLDH) as the biomarker of liver injury in COVID-19 patients, and to correlate between ALT and GLDH in liver injury COVID-19. This is a cross-sectional study that was conducted on a total of 146 subjects, including 73 cases in the COVID-19 group and 73 healthy subjects in the control group. They were age- and sex-matched, ranging from two months to sixteen years. from July 2020 to March 2021, the study was conducted at Ain Shams University’s Children’s Hospital. Multivariate analysis revealed that a glutamate dehydrogenase level of over 3.8 U/L is the most significant variable that affects liver function in patients with COVID-19. There was a significant correlation between GLDH and ALT in COVID-19 patients. Univariate analysis showed that baseline ALT >17 IU/L affected liver function. In COVID-19 patients, univariate analysis shows that baseline AST levels >25 IU/L, serum albumin levels≤ 3 g/dL, influenza vaccination, and non-use of antiviral medication are all linked to impaired liver function. There was a significant correlation between the glutamate dehydrogenase level (GLDH) and serum ferritin. Serum glutamate dehydrogenase levels were significantly higher in COVID-19 patients with severe or critical illness, ICU admission, mechanical ventilation requirement, and non-survival. Serum glutamate dehydrogenase levels were significantly higher in COVID-19 patients who received supplemental oxygen and IVIG treatment. There was a negative correlation between the level of glutamate dehydrogenase (GLDH) and serum creatinine in COVID-19 patients, as well as with the ejection fraction of the heart. Furthermore, there is a significant difference in the level of glutamate dehydrogenase between patients with normal ECHO results and those without. There was a significant correlation between the level of glutamate dehydrogenase and patients with fever, hypoxia, and normal capillary refill time (≤ 3 seconds). |