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Is Fatty Liver Associated with Increased Mortality and Morbidity in Coronavirus Disease 2019 (COVID-19) Pneumonia?
Madan, Kaushal; Rastogi, Ruchi; Bhargava, Richa; Dagar, Vineeta; Singla, Vikas; Sahu, Amit; Singh, Pankaj; Garg, Pallavi; Aggarwal, Bharat; Singh, Ramkrishna K.
  • Madan K; Max Centre for Gastroenterology, Hepatology & Endoscopy, Max Hospitals, Saket, New Delhi 110017, India.
  • Rastogi R; Department of Radiodiagnosis, Max Hospitals, Saket, New Delhi 110017, India.
  • Bhargava R; Max Centre for Gastroenterology, Hepatology & Endoscopy, Max Hospitals, Saket, New Delhi 110017, India.
  • Dagar V; Department of Radiodiagnosis, Max Hospitals, Saket, New Delhi 110017, India.
  • Singla V; Max Centre for Gastroenterology, Hepatology & Endoscopy, Max Hospitals, Saket, New Delhi 110017, India.
  • Sahu A; Department of Radiodiagnosis, Max Hospitals, Saket, New Delhi 110017, India.
  • Singh P; Max Centre for Gastroenterology, Hepatology & Endoscopy, Max Hospitals, Saket, New Delhi 110017, India.
  • Garg P; Max Centre for Gastroenterology, Hepatology & Endoscopy, Max Hospitals, Saket, New Delhi 110017, India.
  • Aggarwal B; Department of Radiodiagnosis, Max Hospitals, Saket, New Delhi 110017, India.
  • Singh RK; Department of Radiodiagnosis, Max Hospitals, Saket, New Delhi 110017, India.
J Clin Exp Hepatol ; 12(5): 1320-1327, 2022.
Article in English | MEDLINE | ID: covidwho-1867325
ABSTRACT

Background:

Fatty liver has been shown to be associated with severe COVID-19 disease without any impact on mortality. This is based on heterogenous criteria for defining both fatty liver as well as the severity parameters. This study aimed to study the impact of fatty liver on the mortality and severity of disease in patients with COVID-19 pneumonia.

Methods:

In a case control study design, patients with COVID-19 pneumonia (COVID-19 computed tomography severity index [CTSI] on high-resolution computed tomography chest of ≥1) with fatty liver (defined as liver to spleen attenuation index ≤5 on noncontrast computed tomography cuts of upper abdomen) were compared with those without fatty liver. The primary outcome measure was in-hospital mortality, and the secondary outcome measures were CTSI score, need for intensive care unit (ICU) care, need for ventilatory support, duration of ICU stay, and duration of hospital stay.

Results:

Of 446 patients with COVID-19 pneumonia, 289 (64.7%)admitted to Max Hospital, Saket, India, between January 1, 2021, and October 30, 2021, had fatty liver. Fifty-nine of 446 patients died during the index admission. In-hospital mortality was not different between patients with fatty liver (38 [13.24%]) or without fatty liver (21 [13.81%]). COVID-19 CTSI score was found to be significantly higher among patients who had fatty liver (13.40 [5.16] vs 11.81 [5.50]; P = 0.003). There was no difference in the requirement of ICU (94 [32%] vs 62 [39.49%]; P = 0.752), requirement of ventilatory support (27 [9.34%] vs 14 [8.91%]; P = 0.385), duration of ICU stay (8.29 [6.87] vs 7.07 [5.71] days; P = 0.208), and duration of hospital stay (10.10 [7.14] vs 10.69 [8.13] days; P = 0.430) between the groups with fatty liver or no fatty liver. Similarly, no difference was found in primary or secondary outcomes measure between the group with severe fatty liver vs mild/moderate or no fatty liver. High total leucocyte count and Fibrosis-4 (FIB-4) index were independently associated with mortality.

Conclusions:

Fatty liver may not be associated with increased mortality or clinical morbidity in patients who have COVID-19 pneumonia.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Language: English Journal: J Clin Exp Hepatol Year: 2022 Document Type: Article Affiliation country: J.jceh.2022.04.013

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Language: English Journal: J Clin Exp Hepatol Year: 2022 Document Type: Article Affiliation country: J.jceh.2022.04.013