Those with fatty liver at 5 times greater risk for death from COVID

Patients with metabolic-associated fatty liver disease or higher transaminases who were then diagnosed with COVID-19 were more likely to die, according to a presenter at the International Liver Congress

“We have to consider that conditions with metabolic dysregulation such as MAFLD and obesity that are characterized by low grade chronic inflammation could overlap with the acute inflammatory state caused by COVID 19 infection resulting in an immune system dysregulation with excessive release of inflammatory mediators and a cytokine storm that could lead to more severe condition for COVID 19 even to multiple organ failures,” Martín Uriel Vázquez Medina, MD, of the Escuela Superior de Medicina, said during a press conference.

Medina and colleagues retrospectively looked at 348 patients (mean age, 54 years; 71.8% men) admitted to a tertiary referral hospital in Mexico City who tested positive for SARS-CoV-2 from April 4, 2020, to June 24, 2020. Of those patients 182 (52%) died.

Investigators classified those patients into three groups: control (n = 80); isolated hypertransaminasemia (IH; n = 185); and the metabolic-associated fatty liver disease (MAFLD; n = 83). Researchers adjusted for sex, age and comorbidities such as diabetes, hypertension and obesity in their analysis.

“In Mexico, MAFLD is a public health main problem. It is present in more than 30% of the population,” Medina said. “It is well documented that patients with persistent liver conditions like cirrhosis or cancer are considered to have an increased risk for morbidity and mortality of any kind of infection, including virus. The aim of this work was to explore if MAFLD was associated with mortality by COVID-19.”

After analysis, Medina reported that the adjusted odds ratio for death compared with the control group was 2.9 for the IH group (95% CI, 1.63-5.34) and 5.1 for the MAFLD group (95% CI, 2.68-9.89).

“The result of patients with elevated transaminases could be explained by some reports that have shown that patients who have died by COVID, a lot of them have alterations in the liver. This is the second most frequent organ affected,” he said.

With more than 30% of the Mexican population having suspected MAFLD, Medina added that these data raise concern for Latin America during the COVID-19 pandemic.

“We also want to show that with these results that Latin American countries that have these problems of obesity, diabetes, MAFLD could be associated with this increased risk for COVID-19,” he said.