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

Abstract

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.