Radiographic Hepatic Steatosis Is Not Associated With Key Clinical Outcomes Among Patients Hospitalized With COVID-19

Hirsh D Trivedi; Robert Wilechansky; Daniela Goyes; Joana Vieira Barbosa; Andrew Canakis; Michelle Lai; Michelle T Long; Zachary Fricker

doi:10.14740/gr1389

Radiographic Hepatic Steatosis Is Not Associated With Key Clinical Outcomes Among Patients Hospitalized With COVID-19

Gastroenterology Res. 2021 Jun;14(3):179-183. doi: 10.14740/gr1389. Epub 2021 Jun 19.

Authors

Hirsh D Trivedi^{1

2

3}, Robert Wilechansky^{4

5

3}, Daniela Goyes¹, Joana Vieira Barbosa^{1

6}, Andrew Canakis^{4

5}, Michelle Lai^{1

2}, Michelle T Long^{4

5

3}, Zachary Fricker^{1

2

3}

Affiliations

¹ Division of Gastroenterology, Hepatology, & Nutrition, Beth Israel Deaconess Medical Center, Boston, MA, USA.
² Harvard Medical School, Boston, MA, USA.
³ These authors contributed equally to this article.
⁴ Evans Department of Medicine, Section of Gastroenterology, Boston University School of Medicine, Boston, MA, USA.
⁵ Boston University School of Medicine, Boston, MA, USA.
⁶ Division of Gastroenterology and Hepatology, Lausanne University Hospital and University of Lausanne, Switzerland.

PMID: 34267833
PMCID: PMC8256898
DOI: 10.14740/gr1389

Abstract

Background: Metabolic syndrome increases adverse outcomes in coronavirus disease 2019 (COVID-19) infection. Hepatic steatosis may increase risk of COVID-19 severity. Current studies evaluating steatosis lack reliable definitions. We aimed to evaluate the association of radiographic hepatic steatosis and clinical outcomes of COVID-19 severity in a diverse cohort.

Methods: We retrospectively identified patients with COVID-19 infection admitted to two US academic hospitals. Outcomes were length of stay, intensive care unit use, mechanical ventilation, and in-hospital mortality. We used Mann-Whitney U-test for continuous measures and Chi-square or Fisher's exact test for categorical measures. Multivariable linear and logistic regression analyses were used to adjust for confounders.

Results: Of the 319 patients, 14% had hepatic steatosis. There were no differences in length of stay (6 (4 - 16) vs. 9 (4 - 18) days, P = 0.6), intensive care unit (24% vs. 32%, P = 0.3), mechanical ventilation (28% vs. 38%, P = 0.32), or in-hospital mortality (7% vs. 17%, P = 0.12). After adjustment, there was no difference in length of stay (β: -14.37, 95% confidence interval (CI): -30.5 - 1.77, P = 0.08), intensive care unit (odds ratio (OR): 0.31, 95% CI: 0.03 - 1.09, P = 0.06), mechanical ventilation (OR: 0.13, 95% CI: 0.02 - 1.09, P = 0.06), or in-hospital mortality (OR: 0.27, 95% CI: 0.06 - 1.16, P = 0.08) among patients with hepatic steatosis.

Conclusion: Radiographic hepatic steatosis was not associated with worse outcomes among patients hospitalized with COVID-19.

Keywords: Coronavirus; Fatty liver; Metabolic syndrome; Steatosis.