Lasting liver injury following COVID-19 infection characterized by ultrasound shear wave elastography

Objective: To assess for lasting hepatic injury using ultrasound shear wave elastography (SWE) in patients following COVID-19 infection. Methods: In this retrospective cohort study, patients with SWE exams between January 2019 and 2022 were categorized into three groups: 1) post-COVID-19 subjects wi...

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Main Authors: Firouzeh Heidari, Theodore T. Pierce, Madeleine Sertic, Siddhi Hegde, David Hunt, Arinc Ozturk, Anthony E. Samir
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:WFUMB Ultrasound Open
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Online Access:http://www.sciencedirect.com/science/article/pii/S2949668324000429
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author Firouzeh Heidari
Theodore T. Pierce
Madeleine Sertic
Siddhi Hegde
David Hunt
Arinc Ozturk
Anthony E. Samir
author_facet Firouzeh Heidari
Theodore T. Pierce
Madeleine Sertic
Siddhi Hegde
David Hunt
Arinc Ozturk
Anthony E. Samir
author_sort Firouzeh Heidari
collection DOAJ
description Objective: To assess for lasting hepatic injury using ultrasound shear wave elastography (SWE) in patients following COVID-19 infection. Methods: In this retrospective cohort study, patients with SWE exams between January 2019 and 2022 were categorized into three groups: 1) post-COVID-19 subjects with positive COVID-19 PCR assay, 2) random sample of contemporaneous unexposed patients with only negative prior COVID-19 PCR tests, and 3) random sample of pre-pandemic patients to address possible undiagnosed COVID-19 infection in the contemporaneous group. The average difference in median Young's modulus between post-COVID-19 patients and controls was calculated using a linear regression model after controlling for confounders. Results: 130 patients (mean age ± SD, 56 years ± 13; 66 women) were evaluated, including 30 patients after COVID-19 infection (mean age ± SD, 53 years ± 11; 15 women), 50 contemporaneous unexposed patients (mean age ± SD, 55 years ± 13; 27 men), and 50 pre-pandemic patients (mean age ± SD, 58 years ± 13; 28 women). SWE scans were performed on General Electric LOGIQ E9 or E10 an average of 44 (range, 12–81) weeks after COVID-19 infection. COVID-19 infection was associated with an average increase in median Young's modulus of 1.5 kPa (95 % CI [0.44, 2.355], p = 0.006) after controlling for age, sex, obesity, history of chronic liver disease, and time period. Post-COVID-19 patients had higher liver stiffness compared to contemporaneous controls (median = 7.58 vs 5.99 kPa, p = 0.001) but not pre-pandemic controls (median = 7.00 kPa, p = 0.51). Conclusions: COVID-19 infection is associated with increased liver stiffness, which may reflect lasting hepatic injury such as ongoing inflammation or the development of fibrosis. US SWE may serve as a noninvasive tool for long-term liver health monitoring after COVID-19 infection.
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spelling doaj-art-14d19614384b46bc93ffd61b155586b32024-12-13T11:09:16ZengElsevierWFUMB Ultrasound Open2949-66832024-12-0122100074Lasting liver injury following COVID-19 infection characterized by ultrasound shear wave elastographyFirouzeh Heidari0Theodore T. Pierce1Madeleine Sertic2Siddhi Hegde3David Hunt4Arinc Ozturk5Anthony E. Samir6Center for Ultrasound Research & Translation, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USACenter for Ultrasound Research & Translation, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Corresponding author. Division of Abdominal Imaging, Department of Radiology, Massachusetts General Hospital, White Bldg., Rm. 270, 55 Fruit Street, Boston, MA 02114, USA.Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USACenter for Ultrasound Research & Translation, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USACenter for Ultrasound Research & Translation, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USACenter for Ultrasound Research & Translation, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USACenter for Ultrasound Research & Translation, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USAObjective: To assess for lasting hepatic injury using ultrasound shear wave elastography (SWE) in patients following COVID-19 infection. Methods: In this retrospective cohort study, patients with SWE exams between January 2019 and 2022 were categorized into three groups: 1) post-COVID-19 subjects with positive COVID-19 PCR assay, 2) random sample of contemporaneous unexposed patients with only negative prior COVID-19 PCR tests, and 3) random sample of pre-pandemic patients to address possible undiagnosed COVID-19 infection in the contemporaneous group. The average difference in median Young's modulus between post-COVID-19 patients and controls was calculated using a linear regression model after controlling for confounders. Results: 130 patients (mean age ± SD, 56 years ± 13; 66 women) were evaluated, including 30 patients after COVID-19 infection (mean age ± SD, 53 years ± 11; 15 women), 50 contemporaneous unexposed patients (mean age ± SD, 55 years ± 13; 27 men), and 50 pre-pandemic patients (mean age ± SD, 58 years ± 13; 28 women). SWE scans were performed on General Electric LOGIQ E9 or E10 an average of 44 (range, 12–81) weeks after COVID-19 infection. COVID-19 infection was associated with an average increase in median Young's modulus of 1.5 kPa (95 % CI [0.44, 2.355], p = 0.006) after controlling for age, sex, obesity, history of chronic liver disease, and time period. Post-COVID-19 patients had higher liver stiffness compared to contemporaneous controls (median = 7.58 vs 5.99 kPa, p = 0.001) but not pre-pandemic controls (median = 7.00 kPa, p = 0.51). Conclusions: COVID-19 infection is associated with increased liver stiffness, which may reflect lasting hepatic injury such as ongoing inflammation or the development of fibrosis. US SWE may serve as a noninvasive tool for long-term liver health monitoring after COVID-19 infection.http://www.sciencedirect.com/science/article/pii/S2949668324000429COVID-19Shear wave elastographyLong COVIDLiver fibrosis
spellingShingle Firouzeh Heidari
Theodore T. Pierce
Madeleine Sertic
Siddhi Hegde
David Hunt
Arinc Ozturk
Anthony E. Samir
Lasting liver injury following COVID-19 infection characterized by ultrasound shear wave elastography
WFUMB Ultrasound Open
COVID-19
Shear wave elastography
Long COVID
Liver fibrosis
title Lasting liver injury following COVID-19 infection characterized by ultrasound shear wave elastography
title_full Lasting liver injury following COVID-19 infection characterized by ultrasound shear wave elastography
title_fullStr Lasting liver injury following COVID-19 infection characterized by ultrasound shear wave elastography
title_full_unstemmed Lasting liver injury following COVID-19 infection characterized by ultrasound shear wave elastography
title_short Lasting liver injury following COVID-19 infection characterized by ultrasound shear wave elastography
title_sort lasting liver injury following covid 19 infection characterized by ultrasound shear wave elastography
topic COVID-19
Shear wave elastography
Long COVID
Liver fibrosis
url http://www.sciencedirect.com/science/article/pii/S2949668324000429
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AT siddhihegde lastingliverinjuryfollowingcovid19infectioncharacterizedbyultrasoundshearwaveelastography
AT davidhunt lastingliverinjuryfollowingcovid19infectioncharacterizedbyultrasoundshearwaveelastography
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