Akademik Veri Yönetim Sistemi
UEGW, Kobenhavn, Danimarka, 15 - 19 Ekim 2023, cilt.11, sa.8, ss.1452-1453
PP1646THE EFFECT OF HEPATOSTEATOSIS AND LIVER FIBROSIS ON THE PROGNOSIS OF HOSPITALIZED COVID-19 PATIENTSB. Çiçek1, M.E. Yıldız2, G. Sağcan3, H. Kuzu Okur3, Ç. Çuhadaroğlu3, A.S. Kocagöz4, N.E. Kutsal5, A.N. Tözün5, S. Yapalı51Acıbadem University School of Medicine, Internal Medicine, Istanbul, Turkey, 2Acıbadem University School of Medicine, Radiology, Istanbul, Turkey, 3Acıbadem University School of Medicine, Pulmonary Medicine, Istanbul, Turkey, 4Acıbadem University School of Medicine, Infectious Diseases and Clinical Microbiology, Istanbul, Turkey, 5Acıbadem University School of Medicine, Gastroenterology, Istanbul, TurkeyContact E-Mail Address: beyzasepin@gmail.comIntroduction: Non-alcoholic Fatty Liver Disease (NAFLD), is a state of hy-perinflammation which is associated with release of pro-inflammatory cytokines. Obesity, diabetes and metabolic syndrome, which are usually accompanied by hepatosteatosis, are risk factors for severe Covid-19 in-fection.Aims & Methods: We aimed to investigate the association of hepatoste-atosis and liver fibrosis by non-invasive markers (FIB-4 and APRI) with the prognosis of Covid-19 disease among hospitalized patients. In this retrospective and observational study, 500 patients with the diagnosis of Covid-19 between March 2020 and March 2022 and underwent Thorax Computed Tomography (CT) were included. Demographics, clinical char-acteristics and laboratory data at admission were recorded. Liver-spleen attenuation value difference (CT L-S) was obtained from CT images and non-invasive fibrosis markers as APRI and FIB-4 scores were calculated (1). Advanced fibrosis was defined as FIB-4>2.67, APRI≥1. Severe outcomes were defined as either intensive care unit (ICU) admission or mortality.Results: Among the patients, 129 (25.8%) were admitted to the ICU, and mortality occurred in 53 (10.3%) cases. According to CT L-S value, hepat-osteatosis was in 32.6% of the cases. 82.8% of cases with hepatosteatosis were male, mean age was 52.6±13.5, 82% were overweight or obese. Hy-pertension and diabetes were the most common comorbidities. Among ICU patients, hepatosteatosis was found in 41.8% and ICU admission was associated with hepatosteatosis (p=0.002). Of the patients with hepat-osteatosis, 58% of patients have FIB-4>1.3 and of these, FIB-4 and APRI score were significantly high in patients with ICU admission and mortality (p=0,001). Of the patients both with hepatosteatosis and advanced fibro-sis, 71% were admitted to the ICU, mortality was seen in 32.5%. Mortality was significantly higher in patients with hepatosteatosis and advanced fibrosis according to the FIB-4 score (p=0.001). In the ROC analysis, combi-nation of FIB-4 score and attenuation had highest sensitivity (sensitivity: 88.37%; Negative Predictive Value 90.85%; p=0.001) in determining the need for ICU need. The need for ICU follow-up was found to be 5 times higher in patients with a high FIB-4 score and low attenuation value [(Odds ratio (OR) 5.101; 95% Confidence Interval (CI): 2.865-9.083)]. The risk fac-tors for the need for intensive care in patients with hepatosteatosis were advanced age, presence of fibrosis, high ferritin and IL-6 level in univari-ate analysis, whilst only high ferritin level was defined as a risk factor in multivariate analysis. Inflammation markers such as IL-6 and ferritin were significantly higher in patients with hepatosteatosis and fibrosis.