Role of Fatty Liver in Coronavirus Disease 2019 Patients' Disease Severity and Hospitalization Length: a Case-control Study

Abstract BACKGROUND AND PURPOSEFatty liver is one of the most common pre-existing illnesses; it can cause liver injury, leading to further complications for 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 administrated before the SARS-CoV-2 pandemic and determine the severity of the disease among fatty liver patients.EXPERIMENTAL APPROACHThis retro-perspective 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 CT-scan; the control group contains patients with available imaging data previous to the COVID-19 pandemic. Patients’ data such as liver Hounsfield unit, days of hospitalization, 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 indicates 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 much more prevalent among COVID-19 against non-COVID-19 patients, and they develop more severe disease and have to be hospitalized for more extended periods.