AST/ALT ratio distinguished COVID-19 patients with different prognosis. Only patients with clear endpoints (recovery and death) were involved in the analysis about prognosis (n = 555). (A) Receiver operating curve (ROC) was utilized to compare the ability of ALT, AST, and AST/ALT ratio to predict death in hospitalized COVID-19 patients. Cut-off values were determined through Youden index. (B) Kaplan–Meier survival analysis in patients with AST/ALT < 1.38 and ≥ 1.38. AUC area under the curve; ***P < 0.001.