Correlation of liver-to-spleen ratio, lung CT scores, clinical, and laboratory findings of COVID-19 patients with two consecutive CT scans

Abstract

Purpose Given the lack of information about abdominal imaging findings and correlation with clinical features of COVID-19, we aimed to evaluate the changes in hepatic attenuation during the course of disease. Our aim was to correlate the liverto-spleen ratio (L/S), clinical, laboratory findings, and lung CT scores of patients with COVID-19 who had two consecutive chest CTs. Methods A retrospective search was performed between March 1, 2020 and April 26, 2020 to identify patients who had positive RT-PCR tests and two unenhanced chest CTs. Scans that were obtained at hospital admission and follow-up were reviewed to assess L/S and lung CT scores. Patients were divided into two groups based on lung CT scores (non-progressive vs progressive). Patient demographics, laboratory findings, length of hospital stay, and survival were noted from electronic medical records. Results Twenty patients in the progressive group and 7 patients in the non-progressive group were identified. The mean L/S of the progressive group (1.13 ± 0.3) was lower than that of the non-progressive group (1.21 ± 0.29) at hospital admission but there was no significant difference between the two groups (p = 0.547). L/S at follow-up was significantly different between the groups as the mean L/S values of the progressive and non-progressive groups were 1.02 ± 0.23 and 1.25 ± 0.29, respectively (p = 0.009). L/S was negatively correlated with AST and ALT (r = − 0.46, p = 0.016 and r = − 0.534, p = 0.004, respectively). There were significant differences between the two groups in terms of WBC, neutrophil, lymphocyte, monocyte, and platelet counts that were obtained at hospital admission. Length of hospital stay was significantly longer in patients in the progressive group (p = 0.035). Conclusions Decrease in L/S may be observed in patients with elevated lung CT scores at follow-up. WBC, neutrophil, lymphocyte, monocyte, and platelet counts at hospital admission may predict the progression of COVID-19.

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

“…In their study, P. [15]. However, our data show no statistically significant differences between the rate of liver density changes across the groups and the development of pneumonia of varying degrees.…”

The liver-to-spleen ratio is a risk factor predicting oxygen demand in COVID-19 patients

“…Concerning liver injury in COVID-19, immune-mediated damage as a result of the severe inflammatory response following SARS-CoV-2 infection [20] , direct cytotoxicities as a result of active viral replication in hepatic cells [21] , and anoxia [22] are thought to be involved. A previous report showed that L/S was reduced in cases that led to severe disease than in those that did not [23] . Therefore, it is possible that a decreased L/S indirectly reflects that hepatic steatosis and mild lobular and portal inflammation result from liver damage due to the above.…”

The Relationship of Liver and Pancreas Density With Chest Computed Tomography Score Progression and Laboratory Findings in Patients With COVID-19

“…There are some studies examining the relationship between COVID-19 severity and liver density and damage, and detecting a decrease in density and an increase in liver damage in severe/ progressive disease. 6,21,[34][35][36][37][38] Guler et al 21 found no significant difference in mean L/S values at admission to hospital, but the L/S value was significantly lower in the progressive group at follow-up. In group comparisons, there was a significant decrease in L/S values on the follow-up CT in the progressive group.…”