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Covid infection may lead to chronic liver damage

According to a recent study presented at the annual meeting of the Radiological Society of North America (RSNA), Covid-19 infections are associated with increased liver stiffness – a marker of liver damage, such as inflammation or fibrosis (the buildup of scar tissue in the liver), and a sign of possible long-term liver injury that could lead to liver cancer and liver failure.

“Our study is part of emerging evidence that Covid-19 infection may lead to liver injury that lasts well after the acute illness,” warned Firouzeh Heidari, a postdoctoral research fellow at the Massachusetts General Hospital in Boston.

The scientists compared liver stiffness of patients with a recorded history of Covid infection to two control groups. Patients from all the three groups underwent ultrasound shear wave elastography – a technique which uses ultrasounds to measure the stiffness of tissue – between 2019 and 2022.

The participants were split into the three groups according to whether they tested positive for Covid and when they underwent elastography. The Covid group consisted of 31 patients who had a positive PCR test at least three months before the elastography exam, the pandemic group of a random sample of 50 patients who underwent elastography during the pandemic, but had a history of only negative PCR test results, and the pre-pandemic group of another random sample of 50 patients who underwent the exam before the onset of the pandemic. The average age of the participants was 53.1 (Covid group), 55.2 (pandemic control group), and 58.2 (pre-pandemic group). In total, there were 67 women across all three groups.

The analysis revealed that Covid-positive patients had a statistically significant higher liver stiffness than patients in both control groups. Surprisingly though, the pre-pandemic control group also had a higher median stiffness than those in the pandemic control group. Although the reasons for this are not yet clearly understood, the scientists believe that they could be the result of changing referral patterns during the pandemic, together with the fact that patients in this group were on average older.

“We don’t yet know if elevated liver stiffness observed after Covid-19 infection will lead to adverse patient outcomes. We are currently investigating whether the severity of acute Covid-related symptoms is predictive of long-term liver injury severity. We hope to enrich our existing database with additional patient data and a broader scope of co-variates to better understand the post-acute effects of Covid-19 within the liver,” Dr. Heidari concluded. 

By Andrei Ionescu, Staff Writer

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