| Abstract: | Background: Fatty liver has been shown to be associated with severe COVID-19 disease without any impact on mortality. This is based on heterogenous criteria for defining both fatty liver as well as the severity parameters. Aim: To study the impact of fatty liver on the mortality and severity of disease in patients with COVID-19 pneumonia. Methods: In a case control study design, patients with COVID-19 pneumonia (COVID-19 CT severity index on HRCT chest of >1) with fatty liver (defined as liver to spleen attenuation index < 5 on non-contrast CT cuts of upper abdomen) were compared to those without fatty liver. The primary outcome measure was in-hospital mortality and secondary outcome measures were CTSI score need for ICU care, need for ventilatory support, duration of ICU stay and duration of Hospital stay. Results: 289 (64.7%) of 446 patients with COVID-19 pneumonia admitted to Max Hospital, Saket, India, between 1/1/2021 and 30/10/2021 had fatty liver. 59 of 446 patients died during the index admission. In-hospital mortality was not different between patients with fatty liver [38 1(3.24%)] or without fatty liver [21 (13.81%)]. COVID-19 CTSI score was found to be significantly higher among patients who had fatty liver [13.40 (5.16) vs 11.81 (5.50); p= 0.003]. There was no difference in the requirement of ICU [94 (32%) vs 62 (39.49%); p=0.752], requirement of ventilatory support [27 (9.34%) vs 14 (8.91%); p=0.385], duration of ICU stay [8.29 (6.87) vs 7.07 (5.71) days; p=0.208] and duration of hospital stay [10.10 (7.14) vs 10.69 (8.13) days; p=0.430] between the groups with fatty liver or no fatty liver. Similarly, no difference was found in primary or secondary outcomes measure between the group with severe fatty liver vs mild/moderate or no fatty liver. High Total leucocyte count and FIB-4 index were independently associated with mortality. Conclusions: Fatty liver may not be associated with increased mortality or clinical morbidity of patients who have COVID-19 pneumonia. |
