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

Abstract

Objective: Abdominal involvement of COVID-19 is a current issue. We aimed to evaluate hepatic and pancreatic density alterations on computed tomography (CT) and to analyze whether these alterations had a relationship with chest CT score and laboratory findings.Methods: Patients with reverse transcription-polymerase chain reactionconfirmed COVID-19 from March 11, 2020, to February 6, 2021, were retrospectively analyzed. Patients were divided into nonprogressive and progressive groups according to their chest CT scores. Liver and pancreas density, and liver-to-spleen (L/S) ratio were calculated. Laboratory findings, medication, intensive care unit stay, and survival were noted.Results: There were 51 patients in the nonprogressive group and 123 patients in the progressive group. The median (minimum to maximum) L/S value of the nonprogressive group was 1 (0.28-1.53) at admission and 1.06 (0.33-1.83) at follow-up ( P < 0.001). In the progressive group, the median L/S value was 1.08 (0.35-1.51) at admission and 0.92 (0.33-1.75) at follow-up ( P < 0.001). A significant difference was found between the 2 groups at admission and follow-up ( P = 0.010 and P < 0.001, respectively). Pancreatic density measured at follow-up was significantly lower in the progressive group ( P = 0.045). In the progressive group, aspartate aminotransferase, total bilirubin, creatinine, urea, C-reactive protein, D-dimer, and white blood cell values were higher; albumin and lymphocyte values were lower ( P < 0.05). Conclusions:Patients with COVID-19 with progressive CT scores may have a decrease in L/S values, and their pancreatic density is lower than nonprogressives. Aspartate aminotransferase, total bilirubin, creatinine, urea, C-reactive protein, D-dimer, and white blood cell values tend to be higher in patients with a high chest CT score.

COVID-19, Possible Hepatic Pathways and Alcohol Abuse—What Do We Know up to 2023?

“…Of note, lower values of liver CT attenuation and liver-to-spleen attenuation ratio were shown to correlate with the severity of COVID-19. Simultaneously, the presence of liver steatosis might concern up to 11% of cases, increasing the risk of hepatic injury [159,160]. Even though the findings of abdominal ultrasound examination are usually irrelevant in patients with normal results of liver function tests, in the case of significant increase in aminotransferases, vascular disorders and cholestatic abnormalities can be observed and related to a higher rate of mortality [161,162].…”

COVID-19 and liver injury: Pathophysiology, risk factors, outcome and management in special populations

“…On abdominal computed tomography (CT) scans of COVID-19 patients, hepatic hypodensity and fat stranding around the gallbladder were observed[ 78 ]. Some findings, such as a decrease in liver-to-spleen attenuation ratio and liver CT attenuation, may be relevant to the severity of the disease[ 79 , 80 ]. Chen et al [ 72 ] demonstrated that hepatic steatosis on CT scan was observed in 11.3% of COVID-19 cases, which enhanced the risk of hepatic dysfunction.…”

Liver involvement in patients with COVID-19 infection: A comprehensive overview of diagnostic imaging features

“…US findings can be confirmed on abdominal CT. According to Lei et al [ 35 ], the most common CT abnormalities in COVID-19 patients include diffuse hypoattenuation of the liver (26%) – more common in severe patients (59%) – and the CT-quantified liver/spleen attenuation that can predict prognosis in COVID-19 patients[ 35 , 36 ]. Furthermore, because the liver is partially included in every chest CT, liver data from chest CT scans performed in many COVID-19 patients can be easily retrieved.…”