CT attenuation values predict liver injury in COVID-19 patients

Abstract Background Liver injuries such as metabolic-associated fatty liver disease, liver fibrosis, and steatosis are common in COVID-19 patients. Unenhanced CT can be used to diagnose the morphological traits of steatosis and cirrhosis. This study aims to provide a clear overview on the association between liver injuries and decreased hepatic CT attenuation values on chest CT images in patients with COVID-19. Main text Measuring HU values can be used as an additional method to diagnose liver injuries, even though HU values alone cannot definitively diagnose specific liver diseases. Chest CT is a common imaging procedure for diagnosing pneumonia, and during this CT examination, the upper abdomen, including the liver and spleen, is incidentally captured on the CT scan. Therefore, the assessment of liver injuries in chest CT of patients with COVID-19 can be performed by measuring the HU value of the liver and spleen. In this review, we summarize all the currently available CT findings in liver injuries associated with decreased hepatic CT attenuation values. Conclusion We found out that liver injuries such as hepatic steatosis and metabolic disease were more frequent in the COVID-19 patient, especially in severe and ICU patients. Compared to control group and COVID-19 patients with mild symptoms, the hepatic CT attenuation values and L/S ratios were lower in research group and severe COVID-19 patients.