Post‐COVID‐19 Liver Injury: Comprehensive Imaging With Multiparametric Ultrasound

• Published in: Journal of ultrasound in medicine Vol. 41; no. 4; pp. 935 - 949
• Main Authors: Radzina, Maija, Putrins, Davis Simanis, Micena, Arta, Vanaga, Ieva, Kolesova, Oksana, Platkajis, Ardis, Viksna, Ludmila
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01-04-2022
• Subjects: COVID-19 - complications; COVID‐19; Humans; Liver - diagnostic imaging; liver injury; multiparametric ultrasound; Original Research; Pandemics; SARS-CoV-2; Ultrasonography; COVID-19; multiparametric ultrasound; liver injury
• ISSN: 0278-4297; 1550-9613
• DOI: 10.1002/jum.15778

Objectives
This study aimed to define patterns of liver injury after severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection using multiparametric ultrasound (mpUS) in a variable patient population with differing severities of COVID‐19.
Methods
Ninety patients were enrolled into the study: 56 had SARS‐CoV‐2 3–9 months prior to enrolment; 34 served as a clinically healthy control group. All patients underwent an mpUS evaluation of the liver (elastography, dispersion and attenuation imaging). Seventy‐six patients had abdominal magnetic resonance (MR) and noncontrast enhanced thoracic computed tomography (CT) scans performed at the same day. All patients were screened for biochemical markers of liver injury.
Results
Liver elasticity, viscosity, and steatosis values were significantly altered in patients after COVID‐19, with particularly higher fibrosis scores compared to the control group (P < .001). Increased biochemical markers of liver injury correlated with changes in mpUS (P < .05), but not with findings on CT or MR findings. Seventeen of 34 hospitalized patients had a moderate or severe course of the disease course with more pronounced changes in mpUS. Increased body mass index was found to influence liver injury and correlated with more severe forms of COVID‐19 (P < .001).
Conclusions
COVID‐19 can cause liver injury observable using mpUS. More severe forms of COVID‐19 and patient obesity are related to increased values of liver damage observed. In comparison to MRI and CT, mpUS appears to be more sensitive to involvement of liver parenchyma. Further research is warranted to establish this promising method for evaluating post‐COVID‐19 liver involvement in the aftermath of the pandemic.