Obesity is a risk factor for COVID-19 infection and is closely related to hepatic steatosis. The present study is aimed at evaluating whether pre-existing hepatic steatosis has an impact on the risk of infection and severity for COVID-19. 

The study conducted univariate and stepwise multivariate logistic regression analyses on liver phenotypic biomarkers to assess if these variables elevated the risk of testing positive and being hospitalized for COVID-19. The study also contrasted previously suggested risk factors associated with COVID-19, including age, ethnicity, gender, obesity, socio-economic status. The study enrolled 502,506 healthy participants, among which 41,791 underwent MRI for assessment of liver fat, liver fibro-inflammatory disease, and liver iron. The positive COVID-19 test was appraised fromtesting data, starting in March 2020 and censored in January 2021. The primary and secondary outcome of the study included liver fat calculated as proton density fat fraction (PDFF%) MRI and body mass index (BMI, Kg/m²) to evaluate prior to February 2020 with the help of MRI of the liver to diagnose hepatic steatosis.

The outcome showed that among the total of 41,791 imaged population, 4,458 had been tested and 1,043 (2.49% of the imaged population) tested positive for COVID-19. Patients with fatty liver (≥10%) were at elevated risk of testing positive and those patients with co-existing obesity and fatty liver, were at higher risk of hospitalization with a positive test result by 5.14 times. 

Thus, the study concluded that patients with hepatic steatosis and concomitant obesity can be at increased risk of infection and hospitalization for COVID-19, suggestive of implementation of public policy measures and modified medicine to protect these high-risk individuals.

Source: Roca-Fernández A, Dennis A, Nicholls R, McGonigle J, Kelly M, Banerjee R, Banerjee A, Sanyal AJ. Hepatic Steatosis, Rather Than Underlying Obesity, Increases the Risk of Infection and Hospitalization for COVID-19. Front Med (Lausanne). 2021 Mar 29;8:636637.