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Hepatic steatosis as an independent risk factor for severe disease in patients with COVID-19: A computed tomography study.
Palomar-Lever, Andres; Barraza, Gustavo; Galicia-Alba, Julieta; Echeverri-Bolaños, Melissa; Escarria-Panesso, Robert; Padua-Barrios, Jorge; Halabe-Cherem, Jose; Hernandez-Molina, Gabriela; Chargoy-Loustaunau, Talia Nila; Kimura-Hayama, Eric.
  • Palomar-Lever A; Práctica Grupal de Neumología Centro Médico ABC, Clínica Lomas Altas Mexico City Mexico.
  • Barraza G; Body Imaging Section CT Scanner Lomas Altas Mexico City Mexico.
  • Galicia-Alba J; Body Imaging Section CT Scanner Lomas Altas Mexico City Mexico.
  • Echeverri-Bolaños M; Radiology Department Instituto Nacional de Cardiología Ignacio Chávez, Grupo CT Scanner Mexico City Mexico.
  • Escarria-Panesso R; Radiology Department Instituto Nacional de Cardiología Ignacio Chávez, Grupo CT Scanner Mexico City Mexico.
  • Padua-Barrios J; Critical Care Unit Hospital Bité Médica Mexico City Mexico.
  • Halabe-Cherem J; Division of Postgraduate Medicine, Faculty of Medicine Universidad Nacional Autónoma de México, Centro Médico ABC Mexico City Mexico.
  • Hernandez-Molina G; Immunology and Rheumatology Department Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán Mexico City Mexico.
  • Chargoy-Loustaunau TN; Body Imaging Section CT Scanner Lomas Altas Mexico City Mexico.
  • Kimura-Hayama E; Body Imaging Section CT Scanner Lomas Altas Mexico City Mexico.
JGH Open ; 4(6): 1102-1107, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-1898843
ABSTRACT
Background and

Aim:

Hepatic steatosis (HS) is associated with diabetes, hypertension, and obesity, comorbidities recently related to COVID-19 severity. Here, we assessed if tomographic HS is also a risk factor for severe COVID-19 pneumonia.

Methods:

We included 213 patients with a positive real time polymerase chain reaction (RT-PCR) test and chest computed tomography (CT) from an out-hospital facility and a hospital. We obtained information on demographics; weight; height; smoking history; diabetes; hypertension; and cardiovascular, lung, and renal disease. Two radiologists scored the CO-RADs system (COVID-19 Reporting and Data System) (1 = normal, 2 = inconsistent, 3-4 = indeterminate, and 5 = typical findings) and the chest CT severity index (≥20 of 40 was considered severe disease). They evaluated the liver-to-spleen ratio (CTL/S) and defined tomographic steatosis as a CTL/S index ≤0.9. We used descriptive statistics, χ2 and t student tests, logistic regression, and reported odds ratio (OR) with 95% confidence interval (CI).

Results:

Of the patients, 61% were men, with a mean age of 51.2 years, 48.3% were CO-RADs 1 and 51.7% CO-RADs 2-5. Severe tomographic disease was present in 103 patients (48.4%), all CO-RADs 5. This group was older; mostly men; and with a higher prevalence of obesity, hypertension, diabetes, and HS (69.9 vs 29%). On multivariate analysis, age (OR 1.058, 95% CI 1.03-1.086, P < 0.0001), male gender (OR 1.9, 95% CI 1.03-3.8, P = 0.04), and HS (OR 4.9, 95% CI 2.4-9.7, P < 0.0001) remained associated.

Conclusion:

HS was independently associated with severe COVID pneumonia. The physiopathological explanation of this finding remains to be elucidated. CTL/S should be routinely measured in thoracic CT scans in patients with COVID-19 pneumonia.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Observational study / Prognostic study Language: English Journal: JGH Open Year: 2020 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Observational study / Prognostic study Language: English Journal: JGH Open Year: 2020 Document Type: Article