Correlation Between COVID-19 Severity, Body Mass Index and Hepatic Steatosis: A Retrograde Cohort Study

Abstract Background Obesity and fatty liver steatosis are already considered metabolic risk factors that may aggravate the severity of COVID-19. This study aims to investigate the correlation between COVID-19 severity, body mass index, and hepatic steatosis. MethodsConsecutive patients with laboratory-confirmed COVID-19, admitted to a hospital devoted to COVID-19 patients, were enrolled in the study. COVID-19 severity was classified as severe versus non-severe based on the condition at time of admission to ICU. Obesity was assessed by Body Mass Index (BMI). CT-scan of the patient liver was used to check for the hepatic steatosis. Fibrosis-4 score was calculated.Results230 patients were enrolled in this study. Obesity strongly and positively correlated with severe COVID-19 illness. Hepatic steatosis had rather less of a correlation with COVID-19 severity. Multivariable-adjusted association between hepatic steatosis or obesity, or both (as exposure) and COVID-19 severity (as the outcome) revealed an increased risk of severe COVID-19 illness with obesity, with hepatic steatosis, and with hepatic steatosis among obese patients. ConclusionsBMI remained the most noticeable factor that strongly correlated with COVID-19 severity. Obesity even in the absence of hepatic steatosis greatly increased the risk of severe COVID-19. This association remained significant after adjusting for likely confounders. The presence of liver steatosis even in non-obese patients increased the risk of severe COVID-19 but to a much lesser degree compared to obesity. The risk of steatosis to COVID-19 severity was greater in those with than those without obesity. This association also remained significant after adjusting for likely confounders