Gastric Neumatosis: When Not to Operate

González, Isabel; Martínez, Daniel Soliva; García, Ana Castro; Ayllon, María José Cantero; Ibáñez, Ricardo de Miguel

doi:10.1016/j.cireng.2018.01.009

Cited by 2 publications

(1 citation statement)

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“…Several comorbidities have been related to a worse prognosis of COVID-19, including a history of cardiovascular disease, diabetes, chronic respiratory disease, hypertension, cancer, and obesity [5][6][7]. The role of liver steatosis detected on imaging studies has been controversial: Zheng et al [8] found steatosis to be a marker of a more severe disease course, as well as others [9][10][11][12], while Campos-Murguia et al [13] found that it was liver fibrosis, assessed by the non-alcoholic fatty liver disease (NAFLD) Fibrosis Score, rather than steatosis, the one associated with the need for invasive mechanical ventilation (IMV) and mortality [13,14]. In opposition to this, Castro et al [15] failed to stablish an association between fibrosis and COVID-19 outcomes; in this work, steatosis was determined by the Hepatic Steatosis Index, and liver fibrosis was assessed by the AST to platelet ratio index, the NAFLD Fibrosis Score, and the Fiborisis-4 index.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2022

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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.

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