NAFLD determined by Dallas Steatosis Index is associated with poor outcomes in COVID-19 pneumonia: a cohort study.

Autor: Moctezuma-Velázquez P; Department of Surgery, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Belisario Domínguez Sección 16, Tlalpan, 14080, Mexico City, Mexico., Miranda-Zazueta G; Department of Surgery, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Belisario Domínguez Sección 16, Tlalpan, 14080, Mexico City, Mexico., Ortiz-Brizuela E; Department of Infectious Diseases, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Belisario Domínguez Sección 16, Tlalpan, 14080, Mexico City, Mexico., Garay-Mora JA; Department of Radiology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Belisario Domínguez Sección 16, Tlalpan, 14080, Mexico City, Mexico., González-Lara MF; Department of Infectious Diseases, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Belisario Domínguez Sección 16, Tlalpan, 14080, Mexico City, Mexico., Tamez-Torres KM; Department of Infectious Diseases, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Belisario Domínguez Sección 16, Tlalpan, 14080, Mexico City, Mexico., Román-Montes CM; Department of Infectious Diseases, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Belisario Domínguez Sección 16, Tlalpan, 14080, Mexico City, Mexico., Díaz-Mejía BA; Department of Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Belisario Domínguez Sección 16, Tlalpan, 14080, Mexico City, Mexico., Pérez-García E; Department of Infectious Diseases, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Belisario Domínguez Sección 16, Tlalpan, 14080, Mexico City, Mexico., Villanueva-Reza M; Department of Infectious Diseases, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Belisario Domínguez Sección 16, Tlalpan, 14080, Mexico City, Mexico., Chapa-Ibargüengoitia M; Department of Radiology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Belisario Domínguez Sección 16, Tlalpan, 14080, Mexico City, Mexico., Uscanga-Domínguez L; Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Belisario Domínguez Sección 16, Tlalpan, 14080, Mexico City, Mexico., Sifuentes-Osornio J; Department of Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Belisario Domínguez Sección 16, Tlalpan, 14080, Mexico City, Mexico., Ponce-de-León A; Department of Infectious Diseases, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Belisario Domínguez Sección 16, Tlalpan, 14080, Mexico City, Mexico., Kershenobich-Stalnikowitz D; Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Belisario Domínguez Sección 16, Tlalpan, 14080, Mexico City, Mexico., Mota-Ayala B; Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Belisario Domínguez Sección 16, Tlalpan, 14080, Mexico City, Mexico., Moctezuma-Velázquez C; Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Belisario Domínguez Sección 16, Tlalpan, 14080, Mexico City, Mexico. mocmocte@hotmail.com.; Division of Gastroenterology, Liver Unit, University of Alberta, Edmonton, AB, Canada. mocmocte@hotmail.com.
Jazyk: angličtina
Zdroj: Internal and emergency medicine [Intern Emerg Med] 2022 Aug; Vol. 17 (5), pp. 1355-1362. Date of Electronic Publication: 2022 Feb 09.
DOI: 10.1007/s11739-022-02933-x
Abstrakt: Coronavirus disease 2019 is a worldwide health challenge. Liver steatosis diagnosis based on imaging studies has been implicated in poor outcomes of COVID-19 pneumonia, but results are inconsistent. The Dallas Steatosis Index (DSI) is an available calculator developed to identify patients with non-alcoholic fatty liver disease (NAFLD). We hypothesized that it would be associated with in-hospital mortality, intensive care unit admission (ICU), and invasive mechanical ventilation (IMV). We conducted a retrospective cohort study on inpatients with confirmed COVID-19 pneumonia between February 26 and April 11, 2020. We computed the DSI on admission, and patients with high DSI were considered with NAFLD. We employed logistic regression to study the association between NAFLD, mortality, ICU admission, and IMV. We studied the association between liver steatosis on computed tomography (CT) and these outcomes, and also between Metabolic Associated Fatty Liver Disease (MAFLD) based on CT findings and risk factors and the outcomes. 470 patients were included; 359 had NAFLD according to the DSI. They had a higher frequency of type 2 diabetes (31% vs 14%, p < 0.001), obesity (58% vs 14%, p < 0.001), and arterial hypertension (34% vs 22%, p = 0.02). In univariable analysis, NAFLD was associated with mortality, ICU admission, and IMV. Liver steatosis by CT and MAFLD were not associated with any of these outcomes. In multivariable logistic regression, high DSI remained significantly associated with IMV and death. High DSI, which can be easily computed on admission, was associated with IMV and death, and its use to better stratify the prognosis of these patients should be explored. On the other hand, liver steatosis by CT and MAFLD were not associated with poor outcomes.
(© 2022. The Author(s), under exclusive licence to Società Italiana di Medicina Interna (SIMI).)
Databáze: MEDLINE
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