Background
Methods
Study design and data
Ethics statement
Participants
Covariate
Outcome
Statistical analysis
Results
Participants and demographic data
Variable | Patients without severe complication (N = 2899) | Patients with severe complication (N = 223) | Univariate OR [95% CI] | P-value | Adjusted OR [95% CI] | P-value |
---|---|---|---|---|---|---|
Sex, male | 838 (28.91) | 121 (54.26) | 2.92 [2.22–3.84] | < 0.001 | 1.15 [1.47–3.13] | < 0.001 |
Age, years | ||||||
< 60 | 1844 (63.61) | 46 (20.63) | 1 (Ref) | – | 1 (Ref) | – |
≥ 60 | 1055 (36.39) | 177 (79.37) | 6.73 [4.82–9.38] | < 0.001 | 3.62 [2.49–5.27] | < 0.001 |
Household income | ||||||
Q1, lowest | 1064 (36.70) | 61 (27.35) | 1 (Ref) | – | 1 (Ref) | – |
Q2 | 704 (24.28) | 45 (20.18) | 1.12 [0.75–1.66] | 0.591 | 1.21 [0.79–1.86] | 0.376 |
Q3 | 491 (16.94) | 40 (17.94) | 1.42 [0.94–2.15] | 0.095 | 1.35 [0.86–2.11] | 0.189 |
Q4, highest | 640 (22.08) | 77 (34.53) | 2.10 [1.48–2.98] | < 0.001 | 1.66 [1.13–2.43] | 0.010 |
Alcohol consumption, frequency per week | ||||||
None | 2310 (79.68) | 200 (89.69) | 1 (Ref) | – | 1 (Ref) | – |
About 1 time per week | 589 (20.32) | 23 (10.31) | 0.45 [0.29–0.70] | < 0.001 | 0.50 [0.31–0.82] | 0.006 |
Smoking habits | ||||||
None | 2473 (85.31) | 152 (68.16) | 1 (Ref) | – | 1 (Ref) | – |
Former smoker | 297 (10.24) | 59 (26.46) | 3.23 [2.34–4.47] | < 0.001 | 1.68 [1.09–2.59] | 0.020 |
Current smoker | 129 (4.45) | 12 (5.38) | 1.51 [0.82–2.80] | 0.186 | 1.03 [0.52–2.06] | 0.928 |
Physical activity | ||||||
< 1 day per week | 603 (20.80) | 60 (26.90) | 1 (Ref) | – | 1 (Ref) | – |
1–4 days per week | 1268 (43.74) | 84 (37.67) | 0.67 [0.47–0.94] | 0.021 | 0.77 [0.52–1.13] | 0.186 |
≥ 5 days per week | 1028 (35.46) | 79 (35.43) | 0.77 [0.54–1.10] | 0.148 | 0.80 [0.54–1.17] | 0.250 |
Body mass index (kg/m2) | 23.83 ± 3.33 | 24.61 ± 3.49 | 1.07 [1.03–1.11] | < 0.001 | – | |
Systolic blood pressure, mmHg | 120.24 ± 15.09 | 128.74 ± 14.74 | 1.04 [1.03–1.04] | < 0.001 | – | |
Diastolic blood pressure, mmHg | 74.22 ± 9.80 | 78.08 ± 10.03 | 1.04 [1.03–1.05] | < 0.001 | – | |
Comorbidities | ||||||
Hypertension | 882 (30.42) | 141 (63.23) | 3.93 [2.96–5.22] | < 0.001 | 1.36 [0.96–1.92] | 0.084 |
Diabetes mellitus | 390 (13.45) | 73 (32.74) | 3.13 [2.32–4.22] | < 0.001 | 1.40 [0.98–2.00] | 0.068 |
Stroke | 99 (3.41) | 27 (12.11) | 3.90 [2.49–6.11] | < 0.001 | 1.37 [0.82–2.28] | 0.231 |
Coronary artery disease | 132 (4.55) | 29 (13.00) | 3.13 [2.04–4.81] | < 0.001 | 1.03 [0.62–1.71] | 0.926 |
Atrial fibrillation | 40 (1.38) | 21 (9.42) | 7.43 [4.30–12.84] | < 0.001 | 2.21 [1.16–4.21] | 0.016 |
Heart failure | 116 (4.00) | 43 (19.28) | 5.73 [3.92–8.39] | < 0.001 | 1.85 [1.15–2.96] | 0.011 |
Asthma | 157 (5.42) | 23 (10.31) | 2.01 [1.27–3.18] | < 0.001 | 1.14 [0.68–1.90] | 0.627 |
Chronic kidney disease | 168 (5.80) | 33 (14.80) | 2.82 [1.89–4.22] | < 0.001 | 1.21 [0.76–1.92] | 0.429 |
Malignancy | 212 (7.31) | 32 (14.35) | 2.12 [1.42–3.17] | < 0.001 | 1.37 [0.88–2.14] | 0.169 |
Aspartate aminotransferase, U/L | 24.15 ± 11.92 | 24.97 ± 10.68 | 1.01 [0.99–1.02] | 0.318 | – | |
Alanine aminotransferase, U/L | 22.98 ± 17.94 | 23.76 ± 14.77 | 1.00 [0.99–1.01] | 0.528 | 0.99 [0.98–1.00] | 0.140 |
Glutamyl transpeptidase, U/L | 25.47 ± 26.44 | 30.58 ± 26.24 | 1.01 [1.00–1.02] | 0.012 | – | – |
Fasting glucose, mmol/L | 5.53 ± 1.55 | 6.17 ± 1.77 | 1.17 [1.09–1.24] | < 0.001 | – | – |
Total cholesterol, mmol/L | 5.06 ± 0.97 | 4.82 ± 1.04 | 0.89 [0.83–0.95] | < 0.001 | 0.95 [0.88–1.02] | 0.203 |
Triglyceride, mmol/L | 1.32 ± 0.93 | 1.58 ± 0.89 | 1.04 [1.02–1.07] | 0.001 | – | – |
HDL cholesterol, mmol/L | 1.47 ± 0.50 | 1.33 ± 0.35 | 0.58 [0.48–0.71] | < 0.001 | – | – |
LDL cholesterol, mmol/L | 2.96 ± 0.86 | 2.76 ± 0.92 | 0.86 [0.80–0.93] | < 0.001 | – | – |
Fatty liver index, tertile | ||||||
T1 | 4.74 ± 2.23 | 5.81 ± 2.28 | 1 (Ref) | – | 1 (Ref) | – |
T2 | 16.52 ± 4.92 | 17.16 ± 4.48 | 2.13 [1.40–3.24] | < 0.001 | 1.24 [0.79–1.97] | 0.354 |
T3 | 48.05 ± 17.76 | 49.76 ± 17.50 | 3.82 [2.58–5.65] | < 0.001 | 1.77 [1.11–2.82] | 0.017 |
Variable | Total | Fatty liver index | P-value* | ||
---|---|---|---|---|---|
T1 (< 9.14) | T2 (9.14–26.23) | T3 (> 26.23) | |||
N | 3122 | 1040 | 1041 | 1041 | |
Fatty liver index, mean | 23.20 ± 21.25 | 4.77 ± 2.24 | 16.57 ± 4.89 | 48.24 ± 17.73 | < 0.001 |
Sex, male | 959 (30.72) | 150 (14.42) | 312 (29.97) | 497 (47.74) | < 0.001 |
Age, years | < 0.001 | ||||
< 60 | 1890 (60.54) | 793 (76.25) | 567 (54.47) | 530 (50.91) | |
≥ 60 | 1232 (39.46) | 247 (23.75) | 474 (45.53) | 511 (49.09) | |
Household income | 0.115 | ||||
Q1, lowest | 1125 (36.03) | 383 (36.83) | 386 (37.08) | 356 (34.20) | |
Q2 | 749 (23.99) | 273 (26.25) | 235 (22.57) | 241 (23.15) | |
Q3 | 531 (17.01) | 171 (16.44) | 178 (17.10) | 182 (17.48) | |
Q4, highest | 717 (22.97) | 213 (20.48) | 242 (23.25) | 262 (25.17) | |
Alcohol consumption, frequency per week | 0.790 | ||||
None | 2510 (80.40) | 838 (80.58) | 842 (80.88) | 830 (79.73) | |
About 1 time per week | 612 (19.60) | 202 (19.42) | 199 (19.12) | 211 (20.27) | |
Smoking habits | < 0.001 | ||||
None | 2625 (84.08) | 967 (92.98) | 900 (86.46) | 758 (72.81) | |
Former smoker | 356 (11.40) | 54 (5.19) | 101 (9.70) | 201 (19.31) | |
Current smoker | 141 (4.52) | 19 (1.83) | 40 (3.84) | 82 (7.88) | |
Physical activity | 0.001 | ||||
< 1 day per week | 663 (21.24) | 185 (17.79) | 218 (20.94) | 260 (24.98) | |
1–4 days per week | 1352 (43.31) | 479 (46.06) | 438 (42.07) | 435 (41.79) | |
≥ 5 days per week | 1107 (35.46) | 376 (36.15) | 385 (36.98) | 346 (33.24) | |
Anthropometric measurements | |||||
Body mass index (kg/m2) | 23.89 ± 3.34 | 21.08 ± 1.96 | 23.76 ± 1.96 | 26.62 ± 3.06 | < 0.001 |
Systolic blood pressure, mmHg | 120.85 ± 15.22 | 113.74 ± 13.66 | 121.30 ± 14.19 | 127.49 ± 14.58 | < 0.001 |
Diastolic blood pressure, mmHg | 74.49 ± 9.86 | 70.57 ± 9.12 | 74.57 ± 9.59 | 78.33 ± 9.32 | < 0.001 |
Comorbidities | |||||
Hypertension | 1023 (32.77) | 142 (13.65) | 351 (33.72) | 530 (50.91) | < 0.001 |
Diabetes mellitus | 463 (14.83) | 49 (4.71) | 146 (14.02) | 268 (25.74) | < 0.001 |
Stroke | 126 (4.04) | 22 (2.12) | 45 (4.32) | 59 (5.67) | < 0.001 |
Coronary artery disease | 161 (5.16) | 26 (2.50) | 64 (6.15) | 71 (6.82) | < 0.001 |
Atrial fibrillation | 61 (1.95) | 13 (1.25) | 17 (1.63) | 31 (2.98) | 0.011 |
Heart failure | 159 (5.09) | 26 (2.50) | 58 (5.57) | 75 (7.20) | < 0.001 |
Asthma | 180 (5.77) | 41 (3.94) | 57 (5.48) | 82 (7.88) | < 0.001 |
Chronic kidney disease | 201 (6.44) | 32 (3.08) | 68 (6.53) | 101 (9.70) | < 0.001 |
Malignancy | 244 (7.82) | 80 (7.69) | 79 (7.59) | 85 (8.17) | 0.873 |
Laboratory findings | |||||
Aspartate aminotransferase, U/L | 24.21 ± 11.83 | 21.07 ± 8.61 | 23.19 ± 8.36 | 28.35 ± 15.75 | < 0.001 |
Alanine aminotransferase, U/L | 23.04 ± 17.73 | 15.85 ± 9.29 | 20.93 ± 10.61 | 32.32 ± 24.54 | < 0.001 |
Glutamyl transpeptidase, U/L | 25.84 ± 26.46 | 15.12 ± 7.01 | 22.11 ± 12.60 | 40.27 ± 39.43 | < 0.001 |
Fasting glucose, mg/dL | 100.32 ± 28.28 | 92.94 ± 16.92 | 99.16 ± 29.03 | 108.86 ± 33.82 | < 0.001 |
Total cholesterol, mg/dL | 194.86 ± 37.60 | 184.57 ± 32.96 | 197.79 ± 37.75 | 202.22 ± 39.56 | < 0.001 |
Triglyceride, mg/dL | 118.56 ± 82.09 | 71.95 ± 27.46 | 109.52 ± 44.97 | 174.15 ± 52.65 | < 0.001 |
HDL cholesterol, mg/dL | 56.62 ± 18.98 | 63.38 ± 13.63 | 56.74 ± 25.42 | 49.75 ± 12.50 | < 0.001 |
LDL cholesterol, mg/dL | 115.00 ± 33.65 | 106.58 ± 29.79 | 119.57 ± 33.67 | 118.93 ± 35.68 | < 0.001 |
Severe complications of COVID-19 | |||||
Mechanical ventilation | 82 (2.63) | 9 (0.87) | 26 (2.50) | 47 (4.51) | < 0.001 |
Intensive care unit care | 126 (4.04) | 19 (1.83) | 42 (4.03) | 65 (6.24) | < 0.001 |
High-flow oxygen therapy | 75 (2.40) | 9 (0.87) | 24 (2.31) | 42 (4.03) | < 0.001 |
Death | 94 (3.01) | 14 (1.35) | 25 (2.40) | 55 (5.28) | < 0.001 |
Composite of outcome | 223 (7.14) | 34 (3.27) | 70 (6.72) | 119 (11.43) | < 0.001 |
Association of FLI with severe complications of COVID-19
Outcome | Case | Univariate OR [95% CI], T3 versus T1 of FLI | P-value | Adjusted OR [95% CI], T3 versus T1 of FLI | P-value |
---|---|---|---|---|---|
Mechanical ventilation | 82 | 5.42 [2.64–11.11] | < 0.001 | 2.38 [1.06–5.35] | 0.035 |
Intensive care unit care | 126 | 3.58 [2.13–6.01] | < 0.001 | 1.92 [1.06–3.50] | 0.032 |
High-flow oxygen therapy | 75 | 4.82 [2.33–9.95] | < 0.001 | 1.84 [0.81–4.19] | 0.148 |
Death | 94 | 4.09 [2.26–7.40] | < 0.001 | 1.43 [0.70–2.92] | 0.329 |
Variable | OR [95% CI]a | P-value | P for interaction |
---|---|---|---|
Alcohol consumption | 0.665 | ||
No alcohol consumption | 2.21 [1.44–3.37] | < 0.001 | |
Alcohol consumption once per week | 1.70 [0.56–5.14] | 0.350 | |
Body mass index (kg/m2) | 0.271 | ||
< 25 | 3.19 [0.91–11.16] | 0.070 | |
≥ 25 | 1.51 [0.96–2.38] | 0.076 |