Retrospective Cohort Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Crit Care Med. May 9, 2021; 10(3): 47-57
Published online May 9, 2021. doi: 10.5492/wjccm.v10.i3.47
Frequency of hepatic steatosis and its association with the pneumonia severity score on chest computed tomography in adult COVID-19 patients
Mehmet Tahtabasi, Tugrul Hosbul, Ergin Karaman, Yasin Akin, Nihat Kilicaslan, Mehmet Gezer, Fatih Sahiner
Mehmet Tahtabasi, Ergin Karaman, Yasin Akin, Nihat Kilicaslan, Mehmet Gezer, Department of Radiology, University of Health Science, Mehmet Akif Inan Education and Research Hospital, Sanliurfa 63000, Turkey
Tugrul Hosbul, Fatih Sahiner, Department of Medical Microbiology, Gulhane Medical Faculty, University of Health Sciences, Ankara 06100, Turkey
Author contributions: Tahtabasi M contributed to the study design, concept, writing the manuscript, and revising the final version; Karaman E contributed to data collection and manuscript revision; Sahiner F contributed to writing and discussion management; Akin Y contributed to data management and manuscript revision, data collection, interpretation of data, and revising of the manuscript; Kilicaslan N contributed to data collection and revision; Gezer M contributed to data collection; Hosbul T contributed to critical revision; All authors read and approved the final manuscript.
Institutional review board statement: This research was approved by the Clinical Research Ethics Committee of Harran University (date: 07.12.2020 and session: 20).
Informed consent statement: The study was retrospective in nature and no specific intervention is described in this article. The medical research center waived informed consent for this study.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: The authors agree to share data if it is permitted by their institution.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mehmet Tahtabasi, MD, Associate Professor, Department of Radiology, University of Health Science, Mehmet Akif Inan Education and Research Hospital, Ertugrul Gazi street, Karakopru, Sanliurfa 63000, Turkey. mehmet.tahtabasi@sbu.edu.tr
Received: January 19, 2021
Peer-review started: January 19, 2021
First decision: February 15, 2021
Revised: February 19, 2021
Accepted: April 22, 2021
Article in press: April 22, 2021
Published online: May 9, 2021
ARTICLE HIGHLIGHTS
Research background

Recent studies on coronavirus disease 2019 (COVID-19) demonstrated that obesity is significantly associated with increased disease severity, clinical outcome, and mortality.

Research motivation

The association between hepatic steatosis, which frequently accompanies obesity, the pneumonia severity score (PSS) evaluated by computed tomography (CT), and the prevalence of steatosis in patients with COVID-19 remains to be elucidated.

Research objectives

The study objective was to assess the frequency of hepatic steatosis in the chest CT of COVID-19 patients and its association with the PSS.

Research methods

This was a retrospective study evaluating the CT of COVID-19 positive and negative patients in a tertiary hospital.

Research results

Of the 485 patients, 274 (56.5%) were defined as the COVID-19-positive group and 211 (43.5%) as the control group. The frequency of hepatic steatosis was significantly higher in the positive group than in the control group (40.9% vs 19.4%, P < 0.001). The average hepatic attenuation values were significantly lower in the positive group than in the control group (45.7 ± 11.4 HU vs 53.9 ± 15.9 HU, P < 0.001). Logistic regression analysis showed that after adjusting for age, hypertension, diabetes mellitus, overweight, and obesity there was almost a 2.2 times greater odds of hepatic steatosis in the COVID-19-positive group than in the controls (odds ratio 2.187; 95% confidence interval: 1.336-3.580, P < 0.001).

Research conclusions

The current study revealed a significantly higher prevalence of hepatic steatosis on CT in COVID-19 patients compared with controls after adjusting for age and comorbidities.

Research perspectives

Liver density and PSS can be easily examined on CT images of COVID-19 patients and the relationship between tomographic severity and steatosis can be evaluated.