COVID-19 and MAFLD/NAFLD: An updated review

Nowroozi, Ali; Momtazmanesh, Sara; Rezaei, Nima

doi:10.3389/fmed.2023.1126491

Cited by 6 publications

(5 citation statements)

References 80 publications

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“…Additionally, the upregulation of proteins facilitating severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) entry, such as ACE2 and TMPRSS2, particularly in obese patients with MASLD, is another factor[ 28 ]. The close association between fatty liver disease and metabolic syndrome suggests that similar harmful pathophysiological processes may contribute[ 29 ]. Our results also indicated that COVID-19 patients with MASLD are at a higher risk of cardiac arrhythmias, including VT. Several MASLD-related pathophysiological factors within the heart result in structural, electrical, and autonomic remodeling, causing arrhythmias[ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Impact of metabolic dysfunction-associated steatotic liver disease on COVID-19 hospitalizations: A propensity-matched analysis of the United States

Sohail,

Ali,

Patel

et al. 2024

World J Virol

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BACKGROUND Metabolic dysfunction-associated steatotic liver disease (MASLD), formally known as nonalcoholic fatty liver disease, is the most common chronic liver disease in the United States. Patients with MASLD have been reported to be at a higher risk of developing severe coronavirus disease 2019 (COVID-19) and death. However, most studies are single-center studies, and nationwide data in the United States is lacking. AIM To study the influence of MASLD on COVID-19 hospitalizations during the initial phase of the pandemic. METHODS We retrospectively analyzed the 2020 National Inpatient Sample (NIS) database to identify primary COVID-19 hospitalizations based on an underlying diagnosis of MASLD. A matched comparison cohort of COVID-19 hospitalizations without MASLD was identified from NIS after 1: N propensity score matching based on gender, race, and comorbidities, including hypertension, heart failure, diabetes, and cirrhosis. The primary outcomes included inpatient mortality, length of stay, and hospitalization costs. Secondary outcomes included the prevalence of systemic complications. RESULTS A total of 2210 hospitalizations with MASLD were matched to 2210 hospitalizations without MASLD, with a good comorbidity balance. Overall, there was a higher prevalence of severe disease with more intensive care unit admissions (9.5% vs 7.2%, P = 0.007), mechanical ventilation (7.2% vs 5.7%, P = 0.03), and septic shock (5.2% vs 2.7%, P <0.001) in the MASLD cohort than in the non-MASLD cohort. However, there was no difference in mortality (8.6% vs 10%, P = 0.49), length of stay (5 d vs 5 d, P = 0.25), and hospitalization costs (42081.5 $ vs 38614$, P = 0.15) between the MASLD and non-MASLD cohorts. CONCLUSION The presence of MAFLD with or without liver cirrhosis was not associated with increased mortality in COVID-19 hospitalizations; however, there was an increased incidence of severe COVID-19 infection. This data (2020) predates the availability of COVID-19 vaccines, and many MASLD patients have since been vaccinated. It will be interesting to see if these trends are present in the subsequent years of the pandemic.

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Section: Discussionmentioning

confidence: 99%

Impact of metabolic dysfunction-associated steatotic liver disease on COVID-19 hospitalizations: A propensity-matched analysis of the United States

Sohail,

Ali,

Patel

et al. 2024

World J Virol

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“…The study enrolled a total of 72 adult participants who tested positive for SARS-CoV-2 via nasopharyngeal swab samples analyzed using real-time polymerase chain reaction (RT-PCR) [31]. All participants were admitted to the hospital between October 2022 and May 2023.…”

Section: Research Approach and Participantsmentioning

confidence: 99%

Genomic Insight into the COVID-19 Severity in MAFLD Patients: A Single-Center Prospective Cohort Study

Buchynskyi,

Oksenych,

Kamyshna

et al. 2024

Preprint

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This study investigated the influence of single nucleotide polymorphisms (SNPs) in genes asso-ciated with the interferon pathway (IFNAR2 rs2236757), antiviral response (OAS1 rs10774671, OAS3 rs10735079), and viral entry (ACE2 rs2074192) on COVID-19 severity and their association with non-alcoholic fatty liver disease (MAFLD). We did not observe a significant association between the investigated SNPs and COVID-19 severity. While the IFNAR2 rs2236757 A allele correlated with higher creatinine levels upon admission and the G allele with lower band neu-trophils upon discharge, these findings require further investigation. The distribution of OAS gene polymorphisms (rs10774671, rs10735079 did not differ between MAFLD and non-MAFLD patients. Our study population's distribution of ACE2 rs2074192 genotypes and alleles differed from the European reference population. Overall, our findings suggest that these specific SNPs may not be major contributors to COVID-19 severity in our patient population, highlighting the potential role of other genetic factors and environmental influences.

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“…Circulating levels of IL-6 are significantly elevated in individuals diagnosed with MAFLD [ 45 ]. The contribution of the inflammatory response to the severity of COVID-19 has been well-established in previous research [ 46 , 47 , 48 ] with clinical deterioration in certain infected patients linked to a virus-induced cytokine “storm” [ 49 ]. The presence of MAFLD augments the cytokine storm induced by the virus through the release of a multitude of pro-inflammatory cytokines, including IL-6 [ 45 ].…”

Section: The Role Of Mafld In the Progression Of Covid-19mentioning

confidence: 99%

The Intersection of COVID-19 and Metabolic-Associated Fatty Liver Disease: An Overview of the Current Evidence

Buchynskyi

Kamyshna

Oksenych

et al. 2023

Viruses

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The global population is currently experiencing the impact of the SARS-CoV-2 coronavirus, which has caused the Coronavirus Disease 2019 (COVID-19) pandemic. With our profound comprehension of COVID-19, encompassing the involvement sequence of the respiratory tract, gastrointestinal system, and cardiovascular apparatus, the multiorgan symptoms of this infectious disease have been discerned. Metabolic-associated fatty liver disease (MAFLD), formerly known as non-alcoholic fatty liver disease (NAFLD), is a pervasive public health concern intricately linked with metabolic dysregulation and estimated to afflict one-fourth of the global adult population. The burgeoning focus on the association between COVID-19 and MAFLD is justified by the potential role of the latter as a risk factor for both SARS-CoV-2 infection and the subsequent emergence of severe COVID-19 symptoms. Investigations have suggested that changes in both innate and adaptive immune responses among MAFLD patients may play a role in determining the severity of COVID-19. The remarkable similarities observed in the cytokine pathways implicated in both diseases imply the existence of shared mechanisms governing the chronic inflammatory responses characterizing these conditions. The effect of MAFLD on the severity of COVID-19 illness remains uncertain, as indicated by conflicting results in cohort investigations.

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COVID-19 and MAFLD/NAFLD: An updated review

Cited by 6 publications

References 80 publications

Impact of metabolic dysfunction-associated steatotic liver disease on COVID-19 hospitalizations: A propensity-matched analysis of the United States

Impact of metabolic dysfunction-associated steatotic liver disease on COVID-19 hospitalizations: A propensity-matched analysis of the United States

Genomic Insight into the COVID-19 Severity in MAFLD Patients: A Single-Center Prospective Cohort Study

The Intersection of COVID-19 and Metabolic-Associated Fatty Liver Disease: An Overview of the Current Evidence

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