The largest study on COVID-19 to date1Guan W-J Ni Z-Y Hu Y et al.Clinical characteristics of 2019 novel coronavirus infection in China.N Engl J Med. 2020; (published online Feb 28.)DOI:10.1056/NEJMoa2002032Crossref Scopus (20278) Google Scholar showed that the prevalence of elevated aminotransferases and bilirubin in people faring worst was at least double that of others. Although clinically significant liver dysfunction was not quantified, this and other studies have led some to suggest that this finding might present clinical challenges.2Zhang C Shi L Wang FS Liver injury in COVID-19: management and challenges.Lancet Gastroenterol Hepatol. 2020; (published online March 4.)http://dx.doi.org/10.1016/S2468-1253(20)30057-1Summary Full Text Full Text PDF Scopus (1321) Google Scholar Close inspection of the available data supports a higher prevalence of abnormal aminotransferase levels in severe COVID-19 disease, but these studies actually suggest that clinically significant liver injury is uncommon, even when data for the most severely ill patients are selected (table).TableLiver test abnormalities from various COVID-19 studies, identifying the most severe disease categories where possibleGroupPatientsAlanine aminotransferase (IU)Aspartate aminotransferase (IU)Prothrombin time (s)Bilirubin (μmol/L)Elevated lactate dehydrogenase, creatinine kinase, or myoglobinMortality (%)Guan et al (2020)ICU or death67Not knownNot knownNot knownNot knownYes22% (day 51)Huang et al (2020)ICU1349 (29–115)44 (32–70)12·2 (11·2–13·4)14·0 (11·9–32·9)Yes38% (day 37)Chen et al (2020)Hospitalised9939 (22–53)34 (26–48)11·3 (1·9)15·1 (7·3)Yes11% (day 24)Wang et al (2020)ICU3635 (19–57)52 (30–70)13·2 (12·3–14·5)11·5 (9·6–18·6)Yes17% (day 34)Shi et al (2020)Hospitalised8146 (30)41 (18)10·7 (0·9)11·9 (3·6)Unclear5% (day 50)Xu et al (2020)Hospitalised6222 (14–34)26 (20–32)Not knownNot knownUnclear0% (day 34)Yang et al (2020)ICU52Not knownNot known12·9 (2·9)*Non-survivor intensive care unit (ICU) group.19·5 (11·6)*Non-survivor intensive care unit (...