Frequency of hepatic steatosis and its association with the pneumonia severity score on chest computed tomography in adult COVID-19 patients

doi:10.5492/wjccm.v10.i3.47

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World Journal of Critical Care Medicine

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2220-3141

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Cohort Study

World J Crit Care Med. May 9, 2021; 10(3): 47-57
Published online May 9, 2021. doi: 10.5492/wjccm.v10.i3.47

Table 1 Comparison of patient variables in the coronavirus disease 2019-positive and control groups

		COVID-19⁺, n = 274 (56.5%)	COVID-19⁻, n = 211 (43.5%)	Total, n = 485	P value
Age (yr)		50.9 ± 10.9	40.4 ± 12.3	46.4 ± 12.7	< 0.001^c
Male gender, n (%)		144 (52.6)	113 (53.6)	257 (53.0)	0.450
Hepatic steatosis, n (%)	Presence	112 (40.9)	41 (19.4)	153 (31.5)	< 0.001^c
Hepatic steatosis, n (%)	Absence	162 (58.1)	170 (80.6)	332 (68.5)	< 0.001^c
Liver's attenuation (HU)		45.7 ± 11.4	53.9 ± 15.9	49.3 ± 14.2	< 0.001^c
Comorbidities
Obesity (BMI ≥ 30 kg/m²)		45 (16.4)	13 (6.2)	58 (12.0)	0.001^b
Overweight (BMI 25–29.9 kg/m²)		153 (55.8)	55 (26.1)	208 (42.9)	< 0.001^c
Diabetes mellitus		68 (24.8)	29 (13.7)	97 (20.0)	0.003^b
Hypertension		107 (39.1)	37 (17.5)	144 (29.7)	< 0.001^c
Cardiac disease		36 (13.1)	23 (10.9)	59 (12.2)	0.455
Chronic lung disease		29 (10.6)	24 (13.7)	53 (10.9)	0.896
No comorbidity¹		136 (49.6)	129 (61.1)	265 (54.6)	0.012^a
Smoking history		57 (20.8)	56 (26.1)	112 (23.1)	0.110
Alcohol usage		4 (1.5)	4 (1.9)	8 (1.6)	0.709

¹Includes obesity, overweight, diabetes mellitus, hypertension, smoking history, heart and lung diseases.

^aP < 0.05.

^bP < 0.01.

^cP < 0.001.

BMI: Body mass index; COVID-19: Coronavirus disease 2019; HU: Hounsfield unit. Data are means ± SD or n (%).

Table 2 Binominal logistic regression analysis of statistically significant data in univariate analysis of patients with coronavirus disease 2019

Variable	OR	95%CI	P-value
Age	1.074	1.052-1.097	0.002^b
Hepatic steatosis	2.187	1.336-3.580	< 0.001^c
Obesity (BMI ≥ 30 kg/m²)	4.810	2.269-10.195	0.001^b
Overweight (BMI 25–29.9 kg/m²)	3.573	2.181-5.853	< 0.001^c
Diabetes mellitus	0.396	0.213-0.736	0.003^b
Hypertension	1.455	0.867-2.442	0.156

^bP < 0.01.

^cP < 0.001.

BMI: Body mass index; CI: Confidence interval; OR: Odds ratio.

Table 3 Comparison of patient variables in those with coronavirus disease 2019 and with or without hepatic steatosis

Variable	Steatosis⁺, n = 112	Steatosis⁻, n = 162	Total, n = 284	P value
Age (yr)	51.2 ± 9.2	50.7 ± 10.1	50.9 ± 10.9	0.321
Male gender, n (%)	65 (58.0)	79 (48.8)	144 (52.6)	0.131
Liver's attenuation, Hounsfield unit	34.2 ± 4.8	53.6 ± 7.2	45.7 ± 11.5	< 0.001^c
Pneumonia severity score	8.6 ± 3.5	6.8 ± 3.2	7.5 ± 3.4	< 0.001^c
Comorbidities
Obesity (BMI ≥ 30 kg/m²)	28 (25.0)	17 (10.5)	45 (16.4)	0.001^b
Overweight (BMI 25-29.9 kg/m²)	69 (61.6)	65 (40.6)	134 (48.9)	< 0.001^c
Diabetes mellitus	33 (29.5)	35 (21.6)	68 (24.8)	0.139
Hypertension	42 (37.5)	65 (40.1)	107 (39.1)	0.662
Cardiac disease	13 (11.6)	23 (14.2)	36 (13.1)	0.533
Chronic lung disease	12 (10.7)	18 (11.1)	30 (10.9)	0.918
No comorbidity¹	54 (48.2)	82 (50.6)	136 (49.6)	0.696
Smoking history	18 (16.1)	39 (24.1)	57 (20.8)	0.109
Alcohol usage	4 (3.6)	0 (0)	4 (1.5)	0.015^a

¹Includes obesity, overweight, diabetes mellitus, hypertension, smoking history, and heart and lung diseases.

^aP < 0.05.

^bP < 0.01.

^cP < 0.001.

BMI: Body mass index. Data are means ± SD or n (%)

Table 4 Correlation between hepatic attenuation value, coronavirus disease 2019 pneumonia severity score, and age

		Liver attenuation value	Pneumonia severity score	Age
Liver attenuation value	r	1	−0.305¹	0.242¹
Liver attenuation value	P value		< 0.001^c	< 0.001^c
Pneumonia severity score	r	−0.305¹	1	0.329¹
Pneumonia severity score	P value	< 0.001^c		< 0.001^c
Age	r	−0.242¹	0.329¹	1
Age	P value	< 0.001^c	< 0.001^c

¹Correlation is significant at the 0.01 level (2-tailed).

^cP < 0.001.

Citation: Tahtabasi M, Hosbul T, Karaman E, Akin Y, Kilicaslan N, Gezer M, Sahiner F. Frequency of hepatic steatosis and its association with the pneumonia severity score on chest computed tomography in adult COVID-19 patients. World J Crit Care Med 2021; 10(3): 47-57
URL: https://www.wjgnet.com/2220-3141/full/v10/i3/47.htm
DOI: https://dx.doi.org/10.5492/wjccm.v10.i3.47