Published online May 9, 2021. doi: 10.5492/wjccm.v10.i3.47
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
Recent studies on coronavirus disease 2019 (COVID-19) demonstrated that obesity is significantly associated with increased disease severity, clinical outcome, and mortality.
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.
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.
This was a retrospective study evaluating the CT of COVID-19 positive and negative patients in a tertiary hospital.
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).
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.
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.