Hepatic steatosis as an independent risk factor for severe disease in patients with COVID-19: A computed tomography study

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, ?2 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?