Changes of hepatic density on unenhanced CT scans can occur in diffuse liver diseases, whether as a decrease in steatosis or an increase in hemochromatosis [14, 15]. Other entities that may alter hepatic density on CT include drug-induced toxicity, acute hepatitis, acute toxic hepatic injury, cirrhosis, and radiation-induced injury [15]. It has been reported that unenhanced CT scans demonstrate diffuse hypoattenuating areas in the liver of patients with viral acute liver failure [16]. Liver-to-spleen ratio (L/S) on unenhanced CT has been used to discriminate hepatic steatosis [17]. Thus, L/S may be helpful in the evaluation of liver injury as it reflects the changes of hepatic attenuation. Given the lack of information in the literature for the assessment of abdominal imaging findings in COVID-19 patients, which may be related to the limited evaluation of the upper abdomen on unenhanced chest CT scans, we aimed to investigate the changes in L/S during the course of disease. The purpose of this study is to correlate the L/S, clinical, laboratory findings, and lung CT scores of COVID-19 patients who had two consecutive chest CT scans.