Physicians must give ‘extra care and attention’ to patients with NAFLD, COVID-19
Click Here to Manage Email Alerts
CHICAGO — Patients with nonalcoholic fatty liver disease had worse COVID-19-related outcomes compared with infected individuals without NAFLD, according to data presented at Digestive Disease Week.
“The COVID-19 pandemic is one of the most significant global public health crises in recent history,” Khaled Alsabbagh Alchirazi, MD, clinical assistant professor of medicine at Cleveland Clinic, told Healio. “Obesity and other metabolic factors can exacerbate the severity of COVID-19. NAFLD is the most common chronic liver condition in the United States and is considered a hepatic manifestation of the metabolic syndrome.”
In a retrospective cohort study using the multi-institutional database TriNetX, Alchirazi and colleagues compared COVID-19-related outcomes among 17,937 patients with NAFLD (cohort 1) and 3,077,926 patients without NAFLD (cohort 2).
Following propensity score matching for age, gender, race, ethnicity and major COVID-19 risk factors, the final study cohort included 17,936 patients in both cohort 1 (mean age, 53.5 years; 53.2% women; 72.7% white) and cohort 2 (mean age, 52.8 years; 52.9% women; 73.2% white).
Researchers assessed outcomes up to 3 months after COVID-19 diagnosis.
“NAFLD was found to be associated with an increased risk of life-threatening COVID-19-related complications, including hospitalization, mechanical intubation and higher mortality, when compared with COVID-19 patients without history of NAFLD,” Alchirazi said.
According to results, patients in cohort 1 had an increased risk for cardiac complications (adjusted OR = 1.64; 95% CI, 1.51-1.75), venous thromboembolism (aOR = 3.01; 95% CI, 2.76-3.29), cerebrovascular accident (aOR = 1.82; 95% CI, 1.62-2.03), acute kidney injury (aOR = 2.59; 95% CI, 2.37-2.83) and peripheral vascular disease (aOR = 1.48; 95% CI, 1.29-1.71).
Patients in cohort 1 also had a higher risk for acute respiratory distress syndrome (aOR = 3.36; 95% CI, 3.12-3.62), ICU-mechanical ventilation (aOR = 3.22; 95% CI, 2.75-3.77) and shock (aOR = 4.35; 95% CI, 3.62-5.23), as well as hospitalization (aOR = 1.2; 95% CI, 1.15-1.26) and mortality (aOR = 2.12; 95% CI, 1.89-2.38).
“Our findings suggest the importance of promoting social awareness regarding the negative impact of metabolic diseases, such as NAFLD, on COVID-19 patients,” Alchirazi said. “Physicians should provide extra care and attention to patients with preexisting NAFLD who are diagnosed with COVID-19. It is crucial to implement a management plan to control the components of metabolic syndrome and NAFLD through lifestyle interventions.”
He added, “While the link between NAFLD and COVID-19 is not yet fully understood, we believe that further studies are necessary to investigate this relationship and identify effective interventions that can help prevent serious health-related outcomes.”
Collapse
Alchirazi AK, et al. Abstract 337: The impact of nonalcoholic fatty liver disease on outcomes in patients with COVID-19: A propensity-matched cohort study. Presented at: Digestive Disease Week; May 6-9, 2023; Chicago (hybrid).
Read more about
Click Here to Manage Email Alerts