Frequency of hepatic steatosis and its association with the pneumonia severity score on chest computed tomography in adult COVID-19 patients.
Frequency of hepatic steatosis and its association with the pneumonia severity score on chest computed tomography in adult COVID-19 patients.
复制标题
DOI：
10.5492/wjccm.v10.i3.47
复制
发表时间：
2021-05-09
期刊：
影响因子：
--
通讯作者：
Sahiner F
中科院分区：
文献类型：
--
作者：
Tahtabasi M;Hosbul T;Karaman E;Akin Y;Kilicaslan N;Gezer M;Sahiner F
最近对冠状病毒疾病2019年(新冠肺炎)的研究表明，肥胖与疾病严重程度、临床结果和死亡率的增加显著相关。经常伴随肥胖的肝脏脂肪变性和通过计算机断层扫描(CT)评估的肺炎严重程度评分(PSS)和新冠肺炎患者脂肪变性的患病率之间的关联仍有待阐明。目的：探讨新冠肺炎患者胸部CT肝脏脂肪变性的发生率及其与PSS的关系。回顾分析485例疑似新冠肺炎的急诊患者的胸部CT表现。将患者分为新冠肺炎阳性[CT和逆转录聚合酶链式反应(RTPCR)阳性]和对照组(CT和RTPCR阴性)。根据受累肺实质体积与肺总体积的比值，对两组CT图像进行PSS评分。肝脏脂肪变性定义为≤40 Hounsfield单位(HU)的肝脏衰减值。新冠肺炎阳性组占56.5%，对照组占43.5%。新冠肺炎阳性组的平均年龄为50.9±10.9岁，明显高于对照组的40.4±12.3岁(P<；0.001)。阳性组肝脂肪变性发生率显著高于对照组(40.9%vs19.4%，P<；0.001)。阳性组肝脏平均衰减值(45.7±11.4HU)明显低于对照组(53.9±15.9HU，P<；0.001)。Logistic回归分析显示，在调整了年龄、高血压、糖尿病、超重和肥胖的因素后，新冠肺炎阳性组发生肝脏脂肪变性的几率几乎是对照组的2.2%(优势比2.187；95%可信区间：1.336-3.580，P<；0.001)。在调整了年龄和合并症后，新冠肺炎患者的肝脏脂肪变性患病率显著高于对照组。这一发现很容易在胸部CT图像上得到评估。
Recent studies of the coronavirus disease 2019 (COVID-19) demonstrated that obesity is significantly associated with increased disease severity, clinical outcome, and mortality. The association between hepatic steatosis, which frequently accompanies obesity, and the pneumonia severity score (PSS) evaluated on computed tomography (CT), and the prevalence of steatosis in patients with COVID-19 remains to be elucidated. To assess the frequency of hepatic steatosis in the chest CT of COVID-19 patients and its association with the PSS. The chest CT images of 485 patients who were admitted to the emergency department with suspected COVID-19 were retrospectively evaluated. The patients were divided into two groups as COVID-19-positive [CT- and reverse transcriptase-polymerase chain reaction (RT-PCR)-positive] and controls (CT- and RT-PCR-negative). The CT images of both groups were evaluated for PSS as the ratio of the volume of involved lung parenchyma to the total lung volume. Hepatic steatosis was defined as a liver attenuation value of ≤ 40 Hounsfield units (HU). Of the 485 patients, 56.5% (n = 274) were defined as the COVID-19-positive group and 43.5% (n = 211) as the control group. The average age of the COVID-19-positive group was significantly higher than that of the control group (50.9 ± 10.9 years vs 40.4 ± 12.3 years, P < 0.001). The frequency of hepatic steatosis in the positive group was significantly higher compared with the control group (40.9% vs 19.4%, P < 0.001). The average hepatic attenuation values were significantly lower in the positive group compared with the control group (45.7 ± 11.4 HU vs 53.9 ± 15.9 HU, P < 0.001). Logistic regression analysis showed that after adjusting for age, hypertension, diabetes mellitus, overweight, and obesity there was almost a 2.2 times greater odds of hepatic steatosis in the COVID-19-positive group than in the controls (odds ratio 2.187; 95% confidence interval: 1.336-3.580, P < 0.001). The prevalence of hepatic steatosis was significantly higher in COVID-19 patients compared with controls after adjustment for age and comorbidities. This finding can be easily assessed on chest CT images.