Liver injury in patients with COVID-19: clinical profiles, CT findings, the correlation of the severity with liver injury

• Published in: Hepatology international 2020-09, Vol.14 (5), p.733-742
• Main Authors: Lei, Ping, Zhang, Lan, Han, Ping, Zheng, Chuansheng, Tong, Qiaoxia, Shang, Haitao, Yang, Fan, Hu, Yu, Li, Xin, Song, Yuhu
• Format: Article
• Language: English
• Subjects: Abdomen; Albumins; Appetite loss; Attenuation; Betacoronavirus - isolation & purification; China - epidemiology; Colorectal Surgery; Computed tomography; Coronavirus Infections - diagnosis; Coronavirus Infections - epidemiology; Coronavirus Infections - physiopathology; Coronaviruses; Cough; COVID-19; Diarrhea; Female; Fever; Functional testing; Gastrointestinal symptoms; Hepatology; Humans; Injuries; Liver; Liver - diagnostic imaging; Liver - metabolism; Liver Diseases - diagnosis; Liver Diseases - epidemiology; Liver Diseases - etiology; Liver Diseases - physiopathology; Liver Function Tests - methods; Male; Medical records; Medicine; Medicine & Public Health; Middle Aged; Nausea; Original; Original Article; Pandemics; Patients; Pneumonia, Viral - diagnosis; Pneumonia, Viral - epidemiology; Pneumonia, Viral - physiopathology; Pulmonary lesions; Retrospective Studies; Risk groups; SARS-CoV-2; Severity of Illness Index; Spleen; Surgery; Tomography, X-Ray Computed - methods; Vomiting
• ISSN: 1936-0533; 1936-0541
• DOI: 10.1007/s12072-020-10087-1

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.