tetano
Editor, Senior Moderator
Dig Dis Sci
. 2020 Sep 27.
doi: 10.1007/s10620-020-06618-3. Online ahead of print.
Hepatic Steatosis Is Associated with Increased Disease Severity and Liver Injury in Coronavirus Disease-19
Vincent L Chen[SUP] 1 [/SUP], Fadi Hawa[SUP] 2 [/SUP], Jeffrey A Berinstein[SUP] 3 [/SUP], Chanakyaram A Reddy[SUP] 3 [/SUP], Ihab Kassab[SUP] 4 [/SUP], Kevin D Platt[SUP] 3 [/SUP], Chia-Yang Hsu[SUP] 3 [/SUP], Calen A Steiner[SUP] 3 [/SUP], Jeremy Louissaint[SUP] 3 [/SUP], Naresh T Gunaratnam[SUP] 5 [/SUP], Pratima Sharma[SUP] 3 [/SUP]
Affiliations
Abstract
Background: Coronavirus disease-2019 (COVID-19) is a global pandemic. Obesity has been associated with increased disease severity in COVID-19, and obesity is strongly associated with hepatic steatosis (HS). However, how HS alters the natural history of COVID-19 is not well characterized, especially in Western populations.
Aims: To characterize the impact of HS on disease severity and liver injury in COVID-19.
Methods: We examined the association between HS and disease severity in a single-center cohort study of hospitalized COVID-19 patients at Michigan Medicine. HS was defined by either hepatic steatosis index > 36 (for Asians) or > 39 (for non-Asians) or liver imaging demonstrating steatosis > 30 days before onset of COVID-19. The primary predictor was HS. The primary outcomes were severity of cardiopulmonary disease, transaminitis, jaundice, and portal hypertensive complications.
Results: In a cohort of 342 patients, metabolic disease was highly prevalent including nearly 90% overweight. HS was associated with increased transaminitis and need for intubation, dialysis, and vasopressors. There was no association between HS and jaundice or portal hypertensive complications. In a sensitivity analysis including only patients with liver imaging > 30 days before onset of COVID-19, imaging evidence of hepatic steatosis remained associated with disease severity and risk of transaminitis.
Conclusions: HS was associated with increased disease severity and transaminitis in COVID-19. HS may be relevant in predicting risk of complications related to COVID-19.
Keywords: Acute liver injury; NAFLD; Outcomes; SARS-CoV-2.
. 2020 Sep 27.
doi: 10.1007/s10620-020-06618-3. Online ahead of print.
Hepatic Steatosis Is Associated with Increased Disease Severity and Liver Injury in Coronavirus Disease-19
Vincent L Chen[SUP] 1 [/SUP], Fadi Hawa[SUP] 2 [/SUP], Jeffrey A Berinstein[SUP] 3 [/SUP], Chanakyaram A Reddy[SUP] 3 [/SUP], Ihab Kassab[SUP] 4 [/SUP], Kevin D Platt[SUP] 3 [/SUP], Chia-Yang Hsu[SUP] 3 [/SUP], Calen A Steiner[SUP] 3 [/SUP], Jeremy Louissaint[SUP] 3 [/SUP], Naresh T Gunaratnam[SUP] 5 [/SUP], Pratima Sharma[SUP] 3 [/SUP]
Affiliations
- PMID: 32980956
- DOI: 10.1007/s10620-020-06618-3
Abstract
Background: Coronavirus disease-2019 (COVID-19) is a global pandemic. Obesity has been associated with increased disease severity in COVID-19, and obesity is strongly associated with hepatic steatosis (HS). However, how HS alters the natural history of COVID-19 is not well characterized, especially in Western populations.
Aims: To characterize the impact of HS on disease severity and liver injury in COVID-19.
Methods: We examined the association between HS and disease severity in a single-center cohort study of hospitalized COVID-19 patients at Michigan Medicine. HS was defined by either hepatic steatosis index > 36 (for Asians) or > 39 (for non-Asians) or liver imaging demonstrating steatosis > 30 days before onset of COVID-19. The primary predictor was HS. The primary outcomes were severity of cardiopulmonary disease, transaminitis, jaundice, and portal hypertensive complications.
Results: In a cohort of 342 patients, metabolic disease was highly prevalent including nearly 90% overweight. HS was associated with increased transaminitis and need for intubation, dialysis, and vasopressors. There was no association between HS and jaundice or portal hypertensive complications. In a sensitivity analysis including only patients with liver imaging > 30 days before onset of COVID-19, imaging evidence of hepatic steatosis remained associated with disease severity and risk of transaminitis.
Conclusions: HS was associated with increased disease severity and transaminitis in COVID-19. HS may be relevant in predicting risk of complications related to COVID-19.
Keywords: Acute liver injury; NAFLD; Outcomes; SARS-CoV-2.