Bilirubin is a breakdown product of hemoglobin. Unconjugated bilirubin is transported to the liver, where it is conjugated and excreted via the bile ducts. Total Bilirubin describes the sum of unconjugated and conjugated bilirubin. Elevated total bilirubin levels can indicate different types of liver damage or an increased hemolysis rate. 
Several systemic reviews of existing studies state elevated total bilirubin as one of the abnormal diagnostic markers in COVID-19 patients. Further, several meta-analysis found increased total bilirubin levels to be linked with an unfavorable progression of COVID-19. [2, 3, 4, 5, 6].
Thus, liver injury has a potential clinical and biological significance in COVID-19 patients. The liver damage might be directly caused by the viral infection of liver cells or drug-induced liver injury. [7, 8]
Therefore, continuous monitoring of liver parameters, such as total bilirubin is advised for prognostication purposes in COVID-19 patients .
For information on DiaSys Total Bilirubin, please refer to:
Bilirubin Auto Total FS
- Thomas L ed. Clinical Laboratory Diagnostics. 1st ed. Frankfurt: TH-Books Verlagsgesellschaft, 1998. p 192–202.
- Rodriguez-Morales AJ, et al. Clinical, laboratory and imaging features of COVID-19: A systematic review and meta-analysis. Travel medicine and infectious disease, 2020, S. 101623.
- Henry BM, et al. Hematologic, biochemical and immune biomarker abnormalities associated with severe illness and mortality in coronavirus disease 2019 (COVID-19): a meta-analysis. Clinical Chemistry and Laboratory Medicine (CCLM), 2020, 1. Jg., Nr. ahead-of-print.
- Lippi G, Plebani M. Laboratory abnormalities in patients with COVID-2019 infection. Clinical Chemistry and Laboratory Medicine (CCLM), 2020, 1. Jg., Nr. ahead-of-print.
- Ruan Q, et al. Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China. Intensive care medicine, 2020, S. 1-3.
- Chen N, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. The Lancet, 2020, 395. Jg., Nr. 10223, S. 507-513.
- Zhang C, et al. Liver injury in COVID-19: management and challenges. The Lancet Gastroenterology & Hepatology, 2020.
- Sun J, et al. COVID‐19 and liver disease. Liver International, 2020.
- Lippi G, Plebani M. The critical role of laboratory medicine during coronavirus disease 2019 (COVID-19) and other viral outbreaks. Clinical Chemistry and Laboratory Medicine (CCLM), 2020, 1. Jg., Nr. ahead-of-print.