THE EFFECTIVENESS OF SHEAR WAVE ELASTOGRAPHY IN THE ASSESSMENT OF LIVER DAMAGE IN PATIENTS WITH POST-COVID SYNDROME

Abstract

The article presents a review of literature data on the aspects of post-covid liver damage, as well as on the diagnostic capabilities of shear wave ultrasound elastography in its assessment. Development of consequences to the new coronavirus infection COVID-19 resulted in an increased interest in their study. In May 2020, the set of symptoms after COVID-19 was combined by the term "post-covid syndrome" and was introduced into the ICD-10 system – (U09.9). The post-covid syndrome is a set of multisystem manifestations of COVID-19, lasting more than 12 weeks, on a permanent basis or with a wave-like course. According to the literature, 35% of patients have liver damage. As part of the study of pathogenetic mechanisms, several theories have now been proposed: direct damaging effect of the virus, immune-mediated inflammation, hypoxia, drug hepatotoxicity and hepatic comorbidity. Laboratorially liver dysfunction in COVID-19 is characterized by an increase in the level of transaminases, intrahepatic cholestasis, signs of hepatic cell insufficiency. Increased ALAT, thrombocytopenia and hypoalbuminemia are proved to be factors of severe course and increased mortality in patients with COVID-19. Therefore, the issues of early instrumental diagnosis of hepatopathies are actualized in this issue. The "gold standard" for instrumental assessment of liver structure is biopsy, but it is limited in use due to the invasiveness of the procedure. According to the WHO experts, priority in the study of post-covid syndrome should be given to the development of new non-invasive and accessible diagnostic methods. Taking into account the success in the use of ultrasound elastography in the diagnosis of diffuse liver diseases in recent years, it seems that the most informative method in the diagnosis of post-covid liver damage is shear wave ultrasound elastography. The advantages of the method are established to be absence of radiation load on the patient and the doctor, the possibility of conducting the study under optimal visual navigation, non-invasiveness, the choice of any zone of interest, assessment of the structure and functional state of the liver. Shear wave ultrasound elastography is a promising innovative way to assess the structure of the liver in patients with post-COVID syndrome and requires further study.