Association between hepatosteatosis and severity of COVID-19 pneumonia: a CT-based study

Year 2025, Volume: 16 Issue: 56, 148 - 154, 16.12.2025

Esra Soyer Güldoğan , Serra Özbal , Yeliz Aktürk , İrfan Şencan , Baki Hekimoğlu

https://doi.org/10.17944/interdiscip.1698641

Abstract

Objective: Recent studies show that comorbidities are a risk factor for coronavirus disease 2019 (COVID-19) pneumonia. We aimed to evaluate whether hepatosteatosis (HS) plays a role in predicting the severity of the disease.
Method: We included 505 patients whose real-time polymerase chain reaction tests were positive and who had a thoracic computed tomography (CT) scan. Age, gender, height-weight, and comorbidities of the patients were noted. Three radiologists re-evaluated thoracic CTs, and the severity score (between 20-40 was considered a severe disease) was determined. Liver and spleen densities were measured by standardizing, the liver-spleen density ratio was selected, and steatosis was defined as ≤0.8. We used X2 and student t-test, logistic regression, and odds ratio with a 95% confidence interval.
Results: In 149 (29.5%) patients, liver/spleen density ratios favored adiposity. The mean tomography severity score of the patients was 16 (±10.5). When we look at the distribution of 192 (38%) patients with a CT severity score of ≥20; the number of patients over 65 years of age and the male gender were higher. We also found a higher rate of HS in this group compared to the group with a lower CT severity score. When the correlation between the patients’ liver/spleen density ratios and the severity of pneumonia was examined, we observed that the severity of the disease increased significantly as the liver/spleen density ratio decreased (p<0.001).
Conclusion: HS and age were independently related with severe COVID-19 pneumonia. For patients who have viral pneumonia, the liver-spleen density ratio might be measured.

Keywords

Viral pneumonia , liver/spleen density ratio , severity index

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