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. 2022 Apr 17;22(1):384.
doi: 10.1186/s12879-022-07370-x.

Association between the fatty liver index and the risk of severe complications in COVID-19 patients: a nationwide retrospective cohort study

Yoonkyung Chang #  1 , Jimin Jeon #  2 , Tae-Jin Song  3 , Jinkwon Kim  4
Affiliations

Association between the fatty liver index and the risk of severe complications in COVID-19 patients: a nationwide retrospective cohort study

Yoonkyung Chang et al. BMC Infect Dis. .

Abstract

Background: Research on the association of non-alcoholic fatty liver disease (NAFLD) with prognosis in COVID-19 has been limited. We investigated the association between the fatty liver index (FLI), a non-invasive and simple marker of NAFLD, and the severe complications of COVID-19 patients in South Korea.

Methods: We included 3122 COVID-19-positive patients from the nationwide COVID-19 cohort dataset in South Korea between January and June 2020. The FLI was calculated using triglyceride, body mass index, glutamyl transpeptidase, and waist circumference, which were obtained from the national health screening program data. Severe complications related to COVID-19 were defined as the composite of mechanical ventilation, intensive care unit treatment, high-oxygen flow therapy, and death within 2 months after a COVID-19 infection. We performed a multivariate logistic regression analysis for the development of severe complications in COVID-19 patients.

Results: The mean ± standard deviation of FLI were 25.01 ± 22.64. Severe complications from COVID-19 occurred in 223 (7.14%) patients, including mechanical ventilation in 82 (2.63%) patients, ICU admission in 126 (4.04%), high-flow oxygen therapy in 75 (2.40%), and death in 94 (3.01%) patients, respectively. The multivariate analysis indicated that the highest tertile (T3) of FLI was positively associated with severe complications from COVID-19 (adjusted odds ratio (OR): 1.77, 95% confidence interval (CI) (1.11-2.82), P = 0.017) compared with the lowest tertile (T1).

Conclusions: Our study demonstrated that FLI, which represents NAFLD, was positively associated with an increased risk of severe complications from COVID-19. FLI might be used as a prognostic marker for the severity of COVID-19.

Keywords: COVID-19; Fatty liver index; Mechanical ventilation; Non-alcoholic fatty liver; Prognosis.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart depicting patient selection. COVID-19 coronavirus disease 2019, RT-PCR real-time reverse transcription-polymerase chain reaction
Fig. 2
Fig. 2
Distribution of fatty liver index according to the presence of severe complications from COVID-19. The vertical dotted lines present the mean values for the fatty liver index in each group with and without severe complications of COVID-19
See this image and copyright information in PMC

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