Abstract
Background and purposeFatty liver is one of the most common pre-existing illnesses; it can cause liver injury, leading to further complications in coronavirus disease 2019 patients. Our goal is to determine if pre-existing fatty liver is more prevalent in hospitalized COVID-19 patients compared to patients admitted before the SARS-CoV-2 pandemic and determine the disease severity among fatty liver patients.Experimental approachThis retrospective study involves a case and a control group consisting of 1162 patients; the case group contains hospitalized COVID-19 patients with positive PCR tests and available chest CT-scan; the control group contains patients with available chest CT-scan previous to the COVID-19 pandemic. Patients’ data such as liver Hounsfield unit, hospitalization length, number of affected lobes, and total lungs involvement score were extracted and compared between the patients.ResultsThe findings indicate that 37.9% of hospitalized COVID-19 patients have a pre-existing fatty liver, which is significantly higher (P < 0.001) than the prevalence of pre-existing fatty liver in control group patients (9.02%). In comparison to hospitalized non-fatty liver COVID-19 patients, data from hospitalized COVID-19 patients with fatty liver indicate a longer hospitalization length (6.81 ± 4.76 P = 0.02), a higher total lungs involvement score (8.73 ± 5.28 P < 0.001), and an increased number of affected lobes (4.42 ± 1.2 P < 0.001).ConclusionThe statistical analysis shows fatty liver is significantly more prevalent among COVID-19 against non-COVID-19 patients, and they develop more severe disease and tend to be hospitalized for more extended periods.
Highlights
It has been more than 1 year since December 29, 2019, that the first confirmed SARS-CoV-2 case emerged from Wuhan city of China [1], which after a long time, still has so many unknown characteristics
The findings indicate that 37.9% of hospitalized COVID-19 patients have a pre-existing fatty liver, which is significantly higher (P < 0.001) than the prevalence of pre-existing fatty liver in control group patients (9.02%)
Fatty liver distribution The study consists of 1162 patients, and it includes a case group of 575 hospitalized patients with confirmed COVID-19 infection and a control group of 587 patients with chest CT scans in 2019
Summary
It has been more than 1 year since December 29, 2019, that the first confirmed SARS-CoV-2 case emerged from Wuhan city of China [1], which after a long time, still has so many unknown characteristics. Non-alcoholic fatty liver disease (NAFLD) is currently the most common form of chronic liver disease affecting adults and children [6] These findings become more crucial when we understand that according to one study in China, up to 50% of the people with SARS-CoV-2 had liver dysfunction at some point during their illness [7]. The most significant modifiable risk factors for the poor prognosis from COVID-19 are obesity and metabolic disease [8, 9] These findings, such as NAFLD, cause the activation of inflammatory pathways [10]. Our goal is to determine if pre-existing fatty liver is more prevalent in hospitalized COVID-19 patients compared to patients admitted before the SARS-CoV-2 pandemic and determine the disease severity among fatty liver patients. Patients’ data such as liver Hounsfield unit, hospitalization length, number of affected lobes, and total lungs involvement score were extracted and compared between the patients
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