Investigating the Association Between Gynecomastia and Fatty Liver and Epicardial Fat in Patients with COVID-19 ^*

Objectives We aimed to determine the association between gynecomastia and hepatic steatosis through liver density and epicardial fat thickness in computed tomography (CT) scans of patients with coronavirus disease 2019 (COVID-19). Materials and Methods In this descriptive-analytical cross-sectional study, gynecomastia, fatty liver, and epicardial fat were measured using a CT scan. Results Among 341 men hospitalized with COVID-19 infection, 35 (10%) were admitted to the intensive care unit (ICU) and 62 (18%) died. The prevalence of gynecomastia and fatty liver was 35% and 20%, respectively. Patients’ age had a direct positive correlation with mortality ( r = 0.21, P < .001) and epicardial fat ( r = 0.28, P < .001). Right-sided and left-sided gynecomastia were associated with the prevalence of fatty liver ( r = 0.11 and P = .05) and epicardial fat ( r = 0.14 and P = .01), respectively. The prevalence of fatty liver was positively correlated to the amount of epicardial fat ( r = 0.12, P = .02) and retro-areolar fat ( r = 0.34, P < .001). Conclusion Bilateral gynecomastia was not associated with mortality or ICU admission, the prevalence of fatty liver, or epicardial and retro-areolar fat volume. But right-sided gynecomastia was associated with the prevalence of fatty liver, and left-sided gynecomastia was associated with epicardial fat. The amount of retro-areolar fat was recognized as a risk factor for the death of patients.