Hepatosteatozun COVID-19 Hastalarında Göğüs BT Şiddet Skorlarının Seyrine Etkisi

Year 2023, Volume: 33 Issue: 5, 491 - 496, 25.10.2023

Ahmet Turan Kaya , Burcu Akman , Veysel Kaya , Şirin Çetin

https://doi.org/10.54005/geneltip.1274160

Abstract

Amaç: Literatürde pnömoni şiddetinin bir göstergesi olan BT şiddet skoru (BT-ŞS) değerlerinin, ardışık BT' lerde hepatosteatoz varlığına göre zamansal değişimi değerlendirilmemiştir. COVID-19 hastalarında, hepatosteatozun BT-ŞS' nin geçici değişimi üzerindeki etkisini araştırmayı amaçladık.
Materyal ve Metotlar: Retrospektif çalışmamıza Aralık 2021 ile Ocak 2022 tarihleri arasında hastanemize başvuran 472 RT-PCR pozitif COVID-19 hastası ( ≥ 18 yaş) dâhil edildi. Akciğerin her lobuna 0 ile 5 arasında değişen toraks BT şiddet skorları atandı ve toplam BT-ŞS elde edildi. Kantitatif analiz için hepatik/dalak atenüasyon oranı <1 ise, hepatosteatoz tanımlandı. BT-ŞS değerlerinin hepatosteatoz varlığına göre zamansal değişimlerini değerlendirmek için Wilcoxon testi kullanıldı. p<0,05 istatistiksel olarak anlamlı kabul edildi.
Bulgular: Toplam 472 hastanın 255/472'si (%54) hepatosteatoz pozitifti. Hepatosteatoz sıklığı, erkek hastalarda anlamlı olarak yüksekti, 167/255 (%65,5) (p<0,001). Ortalama yaş 64.04±14.35 idi. Yoğun bakıma yatış ve hepatosteatoz grupları arasında anlamlı fark yoktu (p=0,269). Mortalite ile hepatosteatoz varlığı arasında anlamlı fark yoktu (p=0,429). Hepatosteatozlu hastalarda 1. ve 2. BT-ŞS arasında anlamlı artış vardı (p<0.001). İkinci CT-SS'deki artış hepatosteatozlu hastalarda hepatosteatozsuz hastalara göre daha yüksekti.
Sonuç: Hepatosteatoz, COVID-19 hastalarında pnömoni şiddetinin geçici değişiminde kötü prognozun bir göstergesi olabilir.

Keywords

COVID-19, Bilgisayarlı Tomografi şiddet skoru, hepatosteatoz, hepatik-dalak atenüasyon oranı

The Effect of Hepatosteatosis on the Course of Chest CT Severity Scores in COVID-19 Patients

Abstract

Background/Aims: In the literature, the temporal variation of CT severity score (CT-SS) values on consecutive CTs, which is an indicator of pneumonia severity, according to the presence of hepatosteatosis was not evaluated. We aimed to investigate the effect of hepatosteatosis on the temporal change of CT-SS in COVID-19 patients.
Material and Methods: Our retrospective study included 472 RT-PCR positive COVID-19 patients ( ≥ 18 years old) admitted to our hospital between December 2021 and January 2022. Chest CT severity scores ranging from 0 to 5 were assigned to each lobe of the lung and total CT-SS was obtained. For quantitative analysis, if the hepatic/splenic attenuation ratio was <1, hepatosteatosis was defined. Wilcoxon test was used to evaluate the temporal changes of CT-SS values relative to the presence of hepatosteatosis. p<0.05 was considered statistically significant.
Results: Of the total 472 patients, 255/472 (54%) were hepatosteatosis-positive. The frequency of hepatosteatosis was significantly higher in male patients, 167/255 (65.5%) (p<0.001). The mean age was 64.04±14.35 years. There was no significant difference between ICU admission and hepatosteatosis groups (p=0.269). There was no significant difference between mortality and the presence of hepatosteatosis (p=0.429). There was a significant increase between the 1st and the 2nd CT-SS in patients with hepatosteatosis (p<0.001). The increase in the second CT-SS was higher in patients with hepatosteatosis than in patients without hepatosteatosis.
Conclusion: Hepatosteatosis may be an indicator of poor prognosis in the temporal change of pneumonia severity in COVID-19 patients.

Keywords

COVID-19, Computed tomography severity score, hepatosteatosis, hepatic-to-splenic attenuation ratio

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