Aim Coronavirus disease 2019 (COVID-19) is a recently encountered disease that was declared a pandemic by WHO in 2020. Obesity and other components of the metabolic syndrome may aggravate the severity of COVID-19. Nonalcoholic fatty liver disease (NAFLD) represents the hepatic manifestation of metabolic syndrome. The aim of this study was to investigate a possible association between MAFLD and COVID-19 severity. Methods We performed a retrospective, case-control study, enrolling 71 consecutive COVID-19 patients who were divided into two groups according to the presence or absence of fatty liver by computed tomography scan. All medical records of eligible patients were reviewed including demographic, clinical, laboratory parameters and data regarding the presence of NAFLD and COVID-19 severity. Results NAFLD was identified in 22/71 (31%) of the study group. Out of 71, thirteen suffered from severe COVID-19. NAFLD patients had more severe COVID-19 compared with non-NAFLD subjects, 8/22 (36.3%) vs. 5/49(10.2%), ( P < 0.005), respectively. Multiple logistic regression analysis showed that NAFLD subjects were more likely to have severe COVID-19 disease (odds ratio 3.57, 95% confidence interval: 1.22, 14.48, P = 0.0031). Conclusion NAFLD represents a high risk for severe COVID-19 irrespective to gender, and independent of metabolic syndrome specifically in male gender. Moreover, obesity, hypertension and metabolic syndrome were also significantly associated with severe COVID-19.

Background Abdominal aortic aneurysm (AAA) and fatty liver disease are both associated with the metabolic syndrome (MS); the aim of this study was to investigate whether patients with AAA are also at a higher risk for fatty liver disease. Methods A case-control retrospective study. Patients diagnosed with AAA were compared with age- and sex-matched controls regarding the prevalence of fatty liver disease. Extracted data include anthropometric parameters, clinical and laboratory data, and liver imaging. Results 995 patients were enrolled in the final analysis, 495 patients with AAA and 500 age- and sex-matched controls. The prevalence of fatty liver disease among AAA subjects was 48.9% compared with 21.2% among the controls ( P <0.005). After adjusting for age, smoking, body mass index, and MS components, the logistic regression analysis indicates that AAA (men: OR 1.29, 95% CI 1.17, 1.49, P =0.001; women: OR 1.23, 95% CI 1.06, 1.43, P =0.002), obesity (men: OR 1.32, 95% CI 1.17, 1.59, P <0.001; women: OR 1.32, 95% CI 1.07, 1.52, P =0.012), hypertension (men: OR 1.23, 95% CI 1.13, 1.46, P =0.001; women: OR 1.13, 95% CI 1.00, 1.33, P =0.045), MS (men: OR 1.31, 95% CI 1.19, 1.53, P =0.001; women: OR 1.28, 95% CI 1.16, 1.42, P =0.002) were associated with non-alcoholic fatty liver disease/non-alcoholic steatohepatitis (NAFLD/NASH). The prevalence of liver cirrhosis was 1.23%; subjects with obesity, diabetes, hypertension, and AAA had increased risk for cirrhosis (OR 1.89, 95% CI 1.18, 3.22, P =0.014; OR 1.27, 95% CI 1.09, 2.72, P =0.0027; OR 2.08, 95% CI 1.29, 3.42, P =0.004; OR 1.73, 95% CI 1.08, 2.87, P =0.027, respectively). Conclusion AAA patients are at increased risk for NAFLD/NASH, may predict advance liver disease and liver cirrhosis.

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