Liver injury in patients with COVID-19: clinical profiles, CT findings, the correlation of the severity with liver injur
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ORIGINAL ARTICLE
Liver injury in patients with COVID‑19: clinical profiles, CT findings, the correlation of the severity with liver injury Ping Lei1,2 · Lan Zhang1,2 · Ping Han1,2 · Chuansheng Zheng1,2 · Qiaoxia Tong3 · Haitao Shang4 · Fan Yang1,2 · Yu Hu5 · Xin Li1,2 · Yuhu Song4 Received: 28 April 2020 / Accepted: 20 August 2020 © Asian Pacific Association for the Study of the Liver 2020
Abstract Background and aims Liver injury is found in some of patients with COVID-19. Liver injury of COVID-19 patients based on severity grading and abdominal radiological signs have not been reported until now. The aim of our study is to determine clinical profiles of the patients based on severity grading, describe abdominal radiological signs, and investigate the correlations of the severity with clinical profiles and radiological signs. Methods This retrospective cohort study included 115 patients with COVID-19 from Jan 2020 to Feb 2020. Medical records of the patients were collected and CT images were reviewed. Results Common clinical manifestations of patients with COVID-19 were fever (68.70%), cough (56.52%), fatigue (31.30%); some of them had gastrointestinal symptoms (diarrhea, 12.17%; nausea or vomiting 7.83%; inappetence, 7.83%). Abnormal liver function was observed in some of patients with COVID-19. Significant differences in the levels of AST, albumin,CRP were observed among different groups classified by the severity. Common findings of upper abdominal CT scan were liver hypodensity (26.09%) and pericholecystic fat stranding (21.27%); liver hypodensity was more frequently found in critical cases (58.82%). The severity of COVID-19 correlated with semi-quantitative CT score of pulmonary lesions, CT-quantified liver/spleen attenuation ratio in patients with COVID-19. Conclusions Some of the patients with COVID-19 displayed liver damage revealed by liver functional tests and upper abdominal CT imaging, and the severity of COVID-19 patients correlated with some of liver functional tests and CT signs; thus, it will allow an earlier identification of high-risk patients for early effective intervention. Keywords COVID-19 · Liver · Clinical profiles · Tomography · X-ray computed Abbreviations CT Computed tomography COVID-19 Coronavirus disease 2019 Ping Lei and Lan Zhang contributed equally to this study. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12072-020-10087-1) contains supplementary material, which is available to authorized users. * Yuhu Song [email protected] Xin Li [email protected] 1
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Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
SARS-CoV-2 The severe acute respiratory syndrome coronavirus 2 2019-nCoV 2019 Novel coronavirus ARDS Acute respiratory distress syndrome MOF Multiple organ failure DILI Drug-induced liver injury ROI Regions of interest ICC Intraclass correlation efficie
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