Characteristics of the liver parenchyma according to the native CT examinations data at the stages of COVID-19 treatment

Objective: to analyze the X-ray liver attenuation values in hospitalized patients with novel coronavirus infection (COVID-19) in relation to the time of disease onset, the severity of pulmonary parenchymal involvement, and the disease outcome.Material and methods. Chest computed tomography (CT) findings in 635 patients hospitalized with COVID-19 were analyzed. CT was performed at various times after the disease onset. The attenuation (CT density) values of the visualized liver upper part were measured by selecting the region of interest on CT images. The extent of the affected lung parenchyma was assessed according to the five-step CT0–4 scale, where CT0 corresponds to the absence of viral pneumonia, CT1 – lung parenchyma involvement less than 25%, CT2 – 25–50% lung volume lesion, CT3 – 50–75% lung volume lesion, CT4 – lung parenchyma involvement more than 75%.Results. In patients with CT0, the liver attenuation was significantly higher than in those with CT1, CT2, CT3, and CT4 (p < 0.01). During the first week of the disease, there was a decrease in liver CT density followed by its increase and return to the initial values (p < 0.0005). The dynamics of liver attenuation in the group of patients who died did not differ significantly from those who survived and recovered (p = 0.107). In the early stage of the disease (0–4 days), the liver attenuation in the group of patients who subsequently died turned out to be significantly lower than in the survivors (p < 0.05).Conclusion. The course of COVID-19 is characterized by a transient decrease in liver CT density. The reduction in liver attenuation does not correlate with the volume of the affected lung parenchyma in patients with CT2–4. The dynamics of liver CT density is not associated with the disease outcome. There is a trend towards more pronounced values of liver attenuation decrease in the early stage of the disease in patients who subsequently died, which requires further research.

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Liver X-ray Attenuation in Patients with Novel Coronavirus Infection (Multislice Computed Tomography Study)

Nikogosova

Бердалин

Gubskiy

et al. 2022

Vestn. rentgenol. radiol.

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Influence of liver attenuation on the severity of course COVID-19: a retrospective cohort study

Shumskaya,

Gonchar,

Mnatsakanyan

et al. 2023

Medicinskij sovet

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Introduction. A high prevalence of decreased liver density has been shown among patients with COVID-19, but there are no convincing data on the cause of this phenomenon. It is still debatable whether decreased liver attenuation is an independent risk factor for the severe course of COVID-19.Aim. Assessment the prognostic value of liver attenuation on CT scan in patients with COVID-19.Materials and methods. Retrospective cohort study. Data of COVID-19 outpatients were analyzed. Inclusion criteria: two chest CT scans, alanine aminotransferase (ALT), aspartate aminotransferase (AST) blood values, polymerase chain reaction to verify SARS-CoV-2. Four comparison groups were assigned according to the severity of lung lesions. Liver attenuation was analyzed by automatic segmentation, with values less than 40 HU being considered pathologic.Results. Data from 499 patients was included. No correlation between ALT and AST and changes in liver attenuation was found. Groups differed in age and liver attenuation on both CT scans. On follow-up CT, low liver density was seen in males (odds ratio (OR) 2.79 (95% CI 1.42–5.47), p-value = 0.003) and in patients with a baseline reduced liver density (OR 60.59 (95% CI 30.51–120.33), p-value < 0.001). Age over 60 years was associated with the development of lung lesions (OR 1.04 (95% CI 1.02–1.06) for extent of lung injury < 25%, OR 1.08 (95% CI 1.05–1.11) for 25–50%, OR 1.1 (95% CI 1.06–1.15) for 25–50%, p-value < 0.001). Low liver attenuation on the primary CT scan increased the odds of severe lung injury (OR 6.9 (95% CI 2.06–23.07), p-value = 0.002).Conclusion. In COVID-19, patients with low liver attenuation are more likely to develop severe lung damage.

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Chitotriosidase activity and dynamics of computed tomography data in COVID-19 patients

Shchelkanovtseva,

Mironova,

Solovev

et al. 2023

SJCEM

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Aim: To assess the relationship between initial plasma chitotriosidase (CHIT) activity and the dynamics of computed tomography (CT) data: lung injury volume, liver and spleen density in COVID-19 hospitalized patients.Material and Methods. The sub-analysis of the study registered in the Clinical Trial Registry with number: NCT04752085 was performed. The data of patients with available CT data of the chest on admission and at least once in dynamics during the period of hospitalization and the initial level of CTS in the blood plasma were analyzed. The density of the liver and spleen was determined in the scanned upper abdominal images, followed by the calculation of the ratio of the density of the liver to the density of the spleen. Results. A total of 121 patients were enrolled in this sub-analysis. Their baseline characteristics were as follows: median age 62 [53;70], males 48,7%. Between the day of admission and 7 [6;9] days of hospitalization, there was a significant increase in mean liver density from 52,04 [45,4; 56,7] to 57,5 [49,8; 62,7] HU and L/S ratio (liver to spleen ratio) 1,05 [0,91; 1,14] to 1,13 [0,99; 1,28], p < 0,001. The dynamics of the volume of lung tissue damage was multidirectional and, in general, did not change significantly. CHIT activity among patients whose lung injury volume increased during the hospitalization was significantly lower (65 [27; 119] nmol/ml/h) compared with patients whose lung injury volume did not change or decreased (124 [53; 232] nmol/ml/h), p = 0.006. The risk of lung injury progression was higher in patients with baseline CHIT level less than 100 nmol/h/mL, (HR 3.1, 95% CI 1.4–6.9).Conclusion. Insufficient increase of CHIT activity can be associated with progression of lung injury, but does not affect the evolution of liver and spleen density as measured by CT.

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Characteristics of the liver parenchyma according to the native CT examinations data at the stages of COVID-19 treatment

Cited by 3 publications

References 19 publications

Liver X-ray Attenuation in Patients with Novel Coronavirus Infection (Multislice Computed Tomography Study)

Liver X-ray Attenuation in Patients with Novel Coronavirus Infection (Multislice Computed Tomography Study)

Influence of liver attenuation on the severity of course COVID-19: a retrospective cohort study

Chitotriosidase activity and dynamics of computed tomography data in COVID-19 patients

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