Yu. F. Shumskaya, A. P. Gonchar, M. G. Mnatsakanyan, I. A. Blokhin, R. V. Reshetnikov, Yu. A. Vasilev
{"title":"肝衰减对病程COVID-19严重程度的影响:一项回顾性队列研究","authors":"Yu. F. Shumskaya, A. P. Gonchar, M. G. Mnatsakanyan, I. A. Blokhin, R. V. Reshetnikov, Yu. A. Vasilev","doi":"10.21518/ms2023-389","DOIUrl":null,"url":null,"abstract":"Introduction . A high prevalence of decreased liver density has been shown among patients with COVID-19, but there are no convincing data on the cause of this phenomenon. It is still debatable whether decreased liver attenuation is an independent risk factor for the severe course of COVID-19. Aim . Assessment the prognostic value of liver attenuation on CT scan in patients with COVID-19. Materials and methods . Retrospective cohort study. Data of COVID-19 outpatients were analyzed. Inclusion criteria: two chest CT scans, alanine aminotransferase (ALT), aspartate aminotransferase (AST) blood values, polymerase chain reaction to verify SARS-CoV-2. Four comparison groups were assigned according to the severity of lung lesions. Liver attenuation was analyzed by automatic segmentation, with values less than 40 HU being considered pathologic. Results . Data from 499 patients was included. No correlation between ALT and AST and changes in liver attenuation was found. Groups differed in age and liver attenuation on both CT scans. On follow-up CT, low liver density was seen in males (odds ratio (OR) 2.79 (95% CI 1.42–5.47), p-value = 0.003) and in patients with a baseline reduced liver density (OR 60.59 (95% CI 30.51–120.33), p-value < 0.001). Age over 60 years was associated with the development of lung lesions (OR 1.04 (95% CI 1.02–1.06) for extent of lung injury < 25%, OR 1.08 (95% CI 1.05–1.11) for 25–50%, OR 1.1 (95% CI 1.06–1.15) for 25–50%, p-value < 0.001). Low liver attenuation on the primary CT scan increased the odds of severe lung injury (OR 6.9 (95% CI 2.06–23.07), p-value = 0.002). Conclusion . In COVID-19, patients with low liver attenuation are more likely to develop severe lung damage.","PeriodicalId":36137,"journal":{"name":"Meditsinskiy Sovet","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2023-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":"{\"title\":\"Influence of liver attenuation on the severity of course COVID-19: a retrospective cohort study\",\"authors\":\"Yu. F. Shumskaya, A. P. Gonchar, M. G. Mnatsakanyan, I. A. Blokhin, R. V. Reshetnikov, Yu. A. Vasilev\",\"doi\":\"10.21518/ms2023-389\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Introduction . A high prevalence of decreased liver density has been shown among patients with COVID-19, but there are no convincing data on the cause of this phenomenon. It is still debatable whether decreased liver attenuation is an independent risk factor for the severe course of COVID-19. Aim . Assessment the prognostic value of liver attenuation on CT scan in patients with COVID-19. Materials and methods . Retrospective cohort study. Data of COVID-19 outpatients were analyzed. Inclusion criteria: two chest CT scans, alanine aminotransferase (ALT), aspartate aminotransferase (AST) blood values, polymerase chain reaction to verify SARS-CoV-2. Four comparison groups were assigned according to the severity of lung lesions. Liver attenuation was analyzed by automatic segmentation, with values less than 40 HU being considered pathologic. Results . Data from 499 patients was included. No correlation between ALT and AST and changes in liver attenuation was found. Groups differed in age and liver attenuation on both CT scans. On follow-up CT, low liver density was seen in males (odds ratio (OR) 2.79 (95% CI 1.42–5.47), p-value = 0.003) and in patients with a baseline reduced liver density (OR 60.59 (95% CI 30.51–120.33), p-value < 0.001). Age over 60 years was associated with the development of lung lesions (OR 1.04 (95% CI 1.02–1.06) for extent of lung injury < 25%, OR 1.08 (95% CI 1.05–1.11) for 25–50%, OR 1.1 (95% CI 1.06–1.15) for 25–50%, p-value < 0.001). Low liver attenuation on the primary CT scan increased the odds of severe lung injury (OR 6.9 (95% CI 2.06–23.07), p-value = 0.002). Conclusion . In COVID-19, patients with low liver attenuation are more likely to develop severe lung damage.\",\"PeriodicalId\":36137,\"journal\":{\"name\":\"Meditsinskiy Sovet\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-11-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Meditsinskiy Sovet\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.21518/ms2023-389\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Meditsinskiy Sovet","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.21518/ms2023-389","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 1
摘要
介绍。在新冠肺炎患者中,肝脏密度降低的发生率很高,但没有令人信服的数据说明这种现象的原因。肝衰减降低是否是COVID-19严重病程的独立危险因素仍存在争议。的目标。CT扫描肝脏衰减对COVID-19患者预后的价值评价。材料和方法。回顾性队列研究。对COVID-19门诊患者数据进行分析。纳入标准:两次胸部CT扫描,谷丙转氨酶(ALT)、天冬氨酸转氨酶(AST)血值,聚合酶链反应验证SARS-CoV-2。根据肺病变的严重程度分为4个对照组。通过自动分割分析肝脏衰减,值小于40 HU被认为是病理的。结果。纳入了499例患者的数据。ALT、AST与肝脏衰减变化无相关性。两组CT扫描的年龄和肝脏衰减程度不同。在随访CT中,男性低肝密度(优势比(OR) 2.79 (95% CI 1.42-5.47), p值= 0.003)和基线肝密度降低的患者(OR 60.59 (95% CI 30.51-120.33), p值<0.001)。年龄超过60岁与肺损伤的发展相关(OR 1.04 (95% CI 1.02-1.06);25%, 25-50% OR 1.08 (95% CI 1.05-1.11), 25-50% OR 1.1 (95% CI 1.06-1.15)。0.001)。原发性CT低肝衰减增加严重肺损伤的几率(OR 6.9 (95% CI 2.06-23.07), p值= 0.002)。结论。在COVID-19中,肝衰减低的患者更容易发生严重的肺损伤。
Influence of liver attenuation on the severity of course COVID-19: a retrospective cohort study
Introduction . A high prevalence of decreased liver density has been shown among patients with COVID-19, but there are no convincing data on the cause of this phenomenon. It is still debatable whether decreased liver attenuation is an independent risk factor for the severe course of COVID-19. Aim . Assessment the prognostic value of liver attenuation on CT scan in patients with COVID-19. Materials and methods . Retrospective cohort study. Data of COVID-19 outpatients were analyzed. Inclusion criteria: two chest CT scans, alanine aminotransferase (ALT), aspartate aminotransferase (AST) blood values, polymerase chain reaction to verify SARS-CoV-2. Four comparison groups were assigned according to the severity of lung lesions. Liver attenuation was analyzed by automatic segmentation, with values less than 40 HU being considered pathologic. Results . Data from 499 patients was included. No correlation between ALT and AST and changes in liver attenuation was found. Groups differed in age and liver attenuation on both CT scans. On follow-up CT, low liver density was seen in males (odds ratio (OR) 2.79 (95% CI 1.42–5.47), p-value = 0.003) and in patients with a baseline reduced liver density (OR 60.59 (95% CI 30.51–120.33), p-value < 0.001). Age over 60 years was associated with the development of lung lesions (OR 1.04 (95% CI 1.02–1.06) for extent of lung injury < 25%, OR 1.08 (95% CI 1.05–1.11) for 25–50%, OR 1.1 (95% CI 1.06–1.15) for 25–50%, p-value < 0.001). Low liver attenuation on the primary CT scan increased the odds of severe lung injury (OR 6.9 (95% CI 2.06–23.07), p-value = 0.002). Conclusion . In COVID-19, patients with low liver attenuation are more likely to develop severe lung damage.