Significance of liver dysfunction associated with decreased hepatic CT attenuation values in Japanese patients with severe COVID-19

BACKGROUND: COVID-19 has emerged as a threat to human health. Liver dysfunction has been reported to occur frequently in patients with COVID-19, although its significance has not yet been elucidated.

METHODS: The subjects were 35 patients with COVID-19, and clinical characteristics were retrospectively analyzed. COVID-19 patients requiring ventilator were classified as having severe COVID-19.

RESULTS: All 35 patients were diagnosed as having mild-to-moderate COVID-19 at admission, but the severity aggravated to severe in 8 patients (22.9%) in hospital. Hepatocellular-type liver injury, defined as elevation of the serum AST and/or ALT levels to ≥ 3 times the ULN, was seen in 2 patients (5.7%), and cholestasis-type liver injury, defined as elevation of the serum ALP, γ-GTP and/or total bilirubin levels to ≥ twice the ULN, was seen in 4 patients (11.4%). A total of 9 patients (25.7%) fulfilled the criteria for liver injury. The percentage of patients with liver injury was higher in patients with severe COVID-19 than in the remaining patients (P = 0.001). Both the hepatic CT attenuation values and the liver-to-spleen attenuation (L/S) ratios at admission were lower in the former patients than in the latter patients (P < 0.001). ROC curve revealed the optimal cut-off value of the L/S ratio of 1.03 for discriminating between patients with severe and non-severe diseases. The hepatic CT attenuation values increased at the remission phase of the disease as compared to the values at admission (P = 0.012).

CONCLUSION: Liver dysfunction associated with reduced hepatic CT attenuation values correlated with the disease severity in patients with COVID-19.

Media Type:

Electronic Article

Year of Publication:

2020

Contained In:

Journal of gastroenterology - Vol. 55, No. 11 (2020), p. 1098-1106

Language:

English

Contributors:

Uchida, Yoshihito
Uemura, Hayato
Yamaba, Shinpei
Hamada, Daisuke
Tarumoto, Norihito
Maesaki, Shigefumi
Mochida, Satoshi

Links:

Volltext

Keywords:

*Tomography, X-Ray Computed
Adult
Aged
Aged, 80 and over
COVID-19
CT values
Coronavirus Infections
Female
Humans
Japan
Journal Article
Liver Diseases
Liver Function Tests
Liver injury
Male
Middle Aged
Pandemics
Pneumonia, Viral
Respiration, Artificial
Retrospective Studies
SARS-CoV-2
Severity of Illness Index
Young Adult

Notes:

Date Completed 26.10.2020

Date Revised 26.10.2020

published: Print-Electronic

Citation Status MEDLINE

Copyright: From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Physical Description:

Online-Ressource

doi:

10.1007/s00535-020-01717-4

PMID:

32776161

PPN (Catalogue-ID):

NLM31444257X