Hepatosteatosis Patients with Pseudocontrast Sign in COVID-19: Relationships with Disease Severity and Survival Times

OpenAlex İngilizce

The aim of the study was to investigate associations between hepatosteatosis (HS) with computed tomography severity score (CT-SS) and survival of coronavirus disease 2019 (COVID-19) patients attending the hospital. Methods: Our study was a retrospective analysis of 435 reverse transcription polymerase-chain reaction-positive COVID-19 patients (aged 18 years) who attended our hospital between September and December 2021. The patient's chest CT parenchymal findings and CT-SSs were reported. For quantitative analysis, HS was defined if hepatic-to-splenic attenuation ratio (CTL/S)<1. In very fatty livers, we defined the hyperdense appearance of vascular structures compared to liver parenchyma as "pseudocontrast sign (PCS). " We divided patients into three groups based on the hepatic attenuation comparison of vascular attenuation. Group 1: no HS, Group 2: HS without PCS, and Group 3: HS with PCS. Results: 210/435 (48.3%) patients were included in Group 1, 184/435 (42.3%) in Group 2, and 41/435 (9.4%) in Group 3. The Mean CTL/S of Group 3 was 0.560.14, which was significantly lower than the other two groups (p<0.001). There was a very significant (p<0.001) negative correlation between CT-SS and CTL/S. There was no significant difference between HS groups with intensive care unit (ICU) admission (p=0.27) and mortality (p=0.64). In multivariate Cox regression analysis, HS with PCS was an 11-fold (p<0.001) risk factor for shortening the time from hospital admission to death and 3-fold (p=0.035) for shortening the time from ICU admission to death. Discussion and Conclusion: In our study, HS with the PCS was significantly associated with CT-SS but not with overall mortality. Consequently, this sign may be an independent indicator of shorter survival times among patients who died. However, multicenter studies are needed in a large patient population.