Purpose Recent studies have demonstrated that obesity is significantly associated with increased disease severity, hospitalizations and mortality in COVID-19, with a potential role in the pathogenesis and prevalence in the new pandemic. The association with hepatic steatosis, however, a condition closely related to obesity within the spectrum of systemic metabolic dysfunctions, remains to be elucidated. We aimed to evaluate the frequency of hepatic steatosis as incidentally detected in chest CT examinations of COVID-19 positive patients in comparison to non-infected controls. Methods A retrospective study was performed with 316 patients (204 RT-PCR positive; 112 RT-PCR negative and chest CT negative). Steatosis was measured with placement of a single ROI in the right lobe of the liver (segments VI-VII) and defined as a liver attenuation value ≤ 40 HU. Results The frequency of hepatic steatosis was higher in the RT-PCR positive group in comparison to controls (31.9% vs. 7.1%, p < 0.001). Logistic linear regression analysis showed a 4.7 times odds of steatosis in the COVID-19 positive group as compared to controls after adjusting for age and sex (OR 4.698; 95% IC 2.12-10.41, p < 0.001). Conclusion A significantly higher prevalence of steatosis was found among COVID-19 positive individuals. These findings are in accordance with other recent studies linking obesity and COVID-19 infection, as there is an intricate relationship between liver steatosis, metabolic syndrome and obesity. Further studies are required to confirm if such association remains after accounting for multiple variables, as well as possible relationships with disease severity and worst clinical outcomes.

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Classificadas assim quando observadas em menos de 1% da população geral, as anomalias arteriais coronarianas não predizem, necessariamente, alto risco de vida. A maioria é clinicamente benigna 1 e não está associada, frequentemente, com outras malformações congênitas cardíacas 2,3. Contudo, as manifestações clínicas podem variar desde pacientes assintomáticos até aqueles que apresentam angina pectoris, infarto do miocárdio, síncope, arritmias e morte súbita 3,4 , e os mecanismos fisiopatológicos são altamente variáveis 5 .

A woman in her 50s presented with a rounded and hypervascular lesion in the right internal iliac lymph node chain, contacting with small branches of the anterior division of the internal iliac artery. Since the lesion matched the blood arterial pool in CT and the patient exhibited multiple vascular abnormalities that suggested segmental arterial mediolysis, a pseudoaneurysm hypothesis was initially made. Arteriography was realised due to the intention for embolisation of the pseudoaneurysm, but the dynamic behaviour during the exam suggested a hypervascular tumour more. An MRI was conducted, bringing new evidence, favouring the possibility of a neoplasm. The lesion excision was performed and sent to pathology. Morphological and immunohistochemical findings suggested a rare case of a fibroblastic reticular cell tumour of the internal iliac lymph node.

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