Association of gynecomastia and fatty liver and epicardial fat in COVID-19 patients

AbstractObjectives:We aimed to determine the association between gynecomastia, hepatic steatosis through liver density and epicardial fat thickness in CT-scans of COVID-19 patients.Methods and Materials:In this descriptive-analytical cross-sectional study, Gynecomastia, fatty liver and epicardial fat were measured using CT-scan. The collected data were analyzed using Graphpad Prism 9 software. A significance level of less than 0.05 was considered.Results:Among 341 men hospitalized with COVID-19 infection, 35 (10%) were admitted to intensive care unit (ICU) and 62 (18%) died. The prevalence of gynecomastia and fatty liver was 35% and 20% respectively. Patients' age had a direct positive correlation with mortality (r=0.21, P<0.001) and epicardial fat (r=0.28, P<0.001). Bilateral gynecomastia was not associated with mortality or ICU admission, the prevalence of fatty liver, and the amount of epicardial and retro-areolar fat. However, right-sided gynecomastia was associated with the prevalence of fatty liver (r=0.11 and P=0.05) and left-sided gynecomastia was associated with epicardial fat (r=0.14 and P=0.01). In this study, the prevalence of fatty liver was positively correlated to the amount of epicardial fat (r = 0.12, P = 0.02) and retro-areolar fat (r = 0.34, P < 0.001).Conclusion:Bilateral gynecomastia was not associated with mortality or ICU admission, prevalence of fatty liver, and epicardial and retro-areolar fat volume. But right-sided gynecomastia was associated with the prevalence of fatty liver and left sided gynecomastia was associated with epicardial fat. The amount of retro-areolar fat was recognized as a risk factor for the death of patients.