Evaluation of systemic involvement of Coronavirus disease 2019 through spleen; size and texture analysis

Abstract

Aim: To investigate the changes in the spleen size, parenchymal heterogeneity, and computed tomography (CT) texture analysis features of patients diagnosed with Coronavirus Disease 2019 (COVID-19) Methods: The size and parenchymal structure of the spleen in 91 patients who underwent thoracic CT examination due to COVID-19 were evaluated. For the evaluation of parenchymal heterogeneity, CT texture analysis was performed using dedicated software (Olea Medical, France). The texture analysis of each case consisted of 15 first-order intensitybased features, 17 gray level co-occurrence matrix-based features, and 9 gray level run length matrix-based features. Results: A total of 91 patients (45 males, 46 females) with a mean age of 54.31±16.33 years (range: 18−81) were included in the study. A statistically significant decrease in spleen size was seen in the follow-up CT examinations (p < 0.001) whereas no statistically significant difference was found between the Hounsfield unit (HU) values. The radiomics consisted of first-order intensity-based features such as 90 th percentile, maximum, interquartile range, range, mean absolute deviation, standard deviation, and variance, all of which showed statistically significant differences (p-values: < 0.001, < 0.001, 0.001, 0.003, 0.001, 0.001, and 0.004, respectively). "Correlation" as a gray level co-occurrence matrixbased feature and "gray level non-uniformity" as a gray level run length matrix-based feature showed statistically differences (p-values: 0.033 and < 0.001, respectively). Conclusions: Although COVID-19 manifests with lung involvement in the early stage, it can also cause systemic involvement, and the spleen may be one of its target organs. A decrease in the spleen size and parenchymal microstructure changes can be observed in the short follow-up time. It is hoped that the changes in the parenchymal microstructure will be demonstrated by a non-invasive method: texture analysis.

Exploring the Correlation Between Splenomegaly and Lung Involvement in COVID-19: A Retrospective Study

“…However, the consistency of HU values was maintained. The radiomics analysis from the study was even more enlightening, revealing discernible discrepancies in various splenic features, hinting at alterations in the parenchymal microstructure of the spleen [ 11 ]. This evidence brings forth the contention that the spleen could be systematically impacted by COVID-19, thus presenting it as a potential target organ.…”

“…This evidence brings forth the contention that the spleen could be systematically impacted by COVID-19, thus presenting it as a potential target organ. The swift transformation in spleen size and its microstructural facets elevates the importance of further probing into the long-lasting implications of the virus on splenic health [ 11 ]. Aksu et al further reinforced the argument of splenic involvement in COVID-19, linking splenomegaly in patients with COVID-19-induced pneumonia to an increase in lung abnormalities.…”

Clinical and radiomic factors for predicting invasiveness in pulmonary ground‑glass opacity

“…In the present study, the regression coefficient of waveletHLL_ngtdm_coarseness was -23.616, which indicated that the more uniform GGO the lower the probability of invasiveness. Firstorder_Maximum is the maximum grey intensity in the region of interest ( 43 ). The regression coefficient of waveletLHH_firstorder_Maximum was -0.007, which indicated that the smaller the maximum grey intensity of GGO the higher the probability of invasiveness.…”

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“…In addition to a specific tropism for the vascular system, direct infection of the lymphatic organs such as the spleen with SARS-CoV-2 has been shown 2 3. Imaging findings range from a significant increase in the size of the spleen in the early stage of infection4 to a size reduction over time 5 6. Complications of splenic involvement in COVID-19 often present as solitary or multifocal splenic infarction 7 8.…”