Assessment of the liver with two‐dimensional shear wave elastography following COVID‐19 infection: A pilot study

Abstract

Introduction/PurposeThe coronavirus disease (COVID‐19) is a widely spread viral infectious disease, which can impact multiple organs, including the liver. Elevated liver enzymes have been reported in COVID‐19 patients; however, potential changes in liver stiffness following the viral infection remain uncertain. The main aim of this pilot study was to determine if there is a significant difference in liver stiffness between individuals who have never been infected with COVID‐19 and those who had been infected with COVID‐19 <6 months, experiencing only mild symptoms. The secondary aim was to compare the liver stiffness between participants infected with COVID‐19 depending on the elapsed time since infection.MethodsTwo‐dimensional shear wave elastography (2D‐SWE) was performed prospectively on 68 participants. Thirty‐four participants had been infected with COVID‐19 (all for <6 months) (COVID‐19 group), and another 34 had never been infected with COVID‐19 (control group). The mean 2D‐SWE measurements of both the COVID‐19 group and the control group were compared using an independent t‐test. The mean 2D‐SWE measurements of the COVID‐19 subgroups A (<2 months), B (2 to <4 months) and C (4 to <6 months) were compared using a one‐way ANOVA test (P < 0.05).ResultsThe (mean ± standard deviation) liver stiffness (kPa) of the COVID‐19 group (5.26 ± 1.63 kPa) was significantly higher than the control group (4.30 ± 0.96 kPa) (P = 0.005). There was no significant difference in liver stiffness among subgroups A (5.20 ± 1.79 kPa), B (4.70 ± 1.53 kPa) and C (5.96 ± 1.48 kPa) (P = 0.143) respectively.DiscussionThe mean liver stiffness of 4.30 ± 0.96k Pa in the control group showed a high probability of being normal as per guidelines. Conversely, the mean liver stiffness of 5.26 ± 1.63 kPa in the COVID‐19 group exhibited a statistically significant increase compared to the control group. However, compensated advanced chronic liver disease was ruled out without other known clinical signs, as per guidelines.ConclusionA statistically significant increase in liver stiffness value was observed in the post‐COVID‐19 infection group compared to the group who had never been infected. This highlights the potential for short‐term impact on liver stiffness associated with COVID‐19 infection. However, it is unclear if these changes in liver stiffness are associated with liver injury. Further study is warranted to investigate the effects of COVID‐19 infection and its long‐term impact on the liver.