Decreased liver density as a potential predictor of severe COVID-19: a retrospective cohort study

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Abstract

Background. To stratify the risk in patients with COVID-19, it is important to understand the parameters that predispose to a severe course. Following risk factors were described: age over 60 years, overweight, male gender, chronic diseases: hypertension, diabetes mellitus. Low liver density on computed tomography (CT) is also considered as a potential risk factor.

Aim. To evaluation whether low liver density can be used as a predictor of severe COVID-19.

Materials and methods. Retrospective single-center cohort study. Patients with COVID-19 treated in a hospital setting, who underwent two CT scans of the thoracic organs in dynamics, were included. The patients were divided into groups according to the severity of the course (groups of moderate course, severe course and lethal outcome). Relation of the investigated factors was estimated using regression analysis.

Results. 99 patients were enrolled; 3 comparison groups were formed (moderate-severe course n=37, severe course n=52, lethal outcome n=8). All groups significantly differed in C-reactive protein levels. According to multivariate regression analysis, COVID-19 severity was influenced by the liver to spleen density ratio as measured by CT scan on admission [odds ratio 12.18 (95% confidence interval 1.67–89.07); p=0.008].

Conclusion. Reduced liver density on CT scan in a patient with COVID-19 may be a predictor of severe course of novel coronavirus infection.

About the authors

Yuliya F. Shumskaya

Research and Practical Clinical Center for Diagnostics and Telemedicine Technologies; Sechenov First Moscow State Medical University (Sechenov University)

Email: shumskayayf@zdrav.mos.ru
ORCID iD: 0000-0002-8521-4045
SPIN-code: 3164-5518

Res. Assist.

Russian Federation, Moscow; Moscow

Dina A. Akhmedzyanova

Sechenov First Moscow State Medical University (Sechenov University)

Email: dina_akhm@mail.ru
ORCID iD: 0000-0001-7705-9754
SPIN-code: 6983-5991

Laboratory Technician

Russian Federation, Moscow

Marina G. Mnatsakanyan

Sechenov First Moscow State Medical University (Sechenov University)

Author for correspondence.
Email: mnatsakanyan08@mail.ru
ORCID iD: 0000-0001-9337-7453
SPIN-code: 2015-1822

D. Sci. (Med.)

Russian Federation, Moscow

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