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Experimental and Clinical Gastroenterology

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Clinical features of COVID-19 in hospitalized patients with non-alcoholic fatty liver disease

https://doi.org/10.31146/1682-8658-ecg-234-2-52-61

Abstract

The COVID-19 pandemic has been a serious challenge for many comorbid patients, including those with pathology of the hepatobiliary tract. Risk factors for severe COVID-19 infection were older age, male gender, and the presence of concomitant diseases. Purpose of the study: To identify risk factors for severe COVID-19 in hospitalized patients with NAFLD. Materials and methods: A retrospective and prospective analysis of 185 medical records of patients hospitalized with COVID-19 in infectious diseases hospitals in Moscow from June to August 2021 was carried out. Study results: Patients with NAFLD hospitalized with COVID-19 compared to the comparison group were older, had a higher comorbidity index, a high body mass index (BMI) and longer hospitalization. Analysis of laboratory parameters of ALT, AST, CRP, GGTP over time revealed a statistically significant connection between the parameters of cytolysis and inflammation and the need for emergency respiratory support (ventilation). Conclusion: Risk factors for severe COVID-19 in hospitalized patients with NAFLD are older age, male gender, increased weight, high rates of cytolysis and inflammation upon admission and exceeding them on the 7th day of hospitalization, which requires additional measures of emergency therapy, respiratory support and, consequently, longer hospitalization.

About the Authors

S. A. Alieva
Semey Medical University; N. I. Pirogov Russian National Research Medical University
Russian Federation


I. G. Nikitin
N. I. Pirogov Russian National Research Medical University
Russian Federation


I. V. Vasilyeva
N. I. Pirogov Russian National Research Medical University
Russian Federation


References

1. COVID - 19 - infection: WHO Resources - https://www.who.int/ru/emergencies/diseases/novel-coronavirus-2019 (accessed: 02.02.2025.)

2. Li J., Huang D.Q., Zou B. et al. Epidemiology of COVID-19: A systematic review and meta-analysis of clinical characteristics, risk factors, and outcomes. J Med Virol. 2021;93(3):1449-1458. doi: 10.1002/jmv.26424.

3. Younossi Z.M., Golabi P., Paik J.M. et al. The global epidemiology of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH): a systematic review. Hepatology. 2023;77(4):1335-1347. doi: 10.1097/HEP.0000000000000004.

4. Jagirdhar G.S.K., Qasba R.K., Pattnaik H. et al. Association of non-alcoholic fatty liver and metabolic-associated fatty liver with COVID-19 outcomes: A systematic review and meta-analysis. World J Gastroenterol. 2023;29(21):3362-3378. doi: 10.3748/wjg.v29.i21.3362.

5. Guan W.J., Ni ZY., Hu Y.et al. China Medical Treatment Expert Group for Covid-19. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020;382(18):1708-1720. doi: 10.1056/NEJMoa2002032.

6. Grimaudo S., Amodio E., Pipitone RM. et al. PNPLA3 and TLL-1 Polymorphisms as Potential Predictors of Disease Severity in Patients With COVID-19. Front Cell Dev Biol. 2021;9:627914. doi: 10.3389/fcell.2021.627914.

7. Ji D., Zhang D., Xu J. et al. Prediction for Progression Risk in Patients With COVID-19 Pneumonia: The CALL Score. Clin Infect Dis. 2020;71(6):1393-1399. doi: 10.1093/cid/ciaa414.

8. Targher G., Byrne CD., Tilg H. NAFLD and increased risk of cardiovascular disease: clinical associations, pathophysiological mechanisms and pharmacological implications. Gut. 2020;69(9):1691-1705. doi: 10.1136/gutjnl-2020-320622.

9. Ji D., Qin E., Xu J. et al. Non-alcoholic fatty liver diseases in patients with COVID-19: A retrospective study. J Hepatol. 2020;73(2):451-453. doi: 10.1016/j.jhep.2020.03.044.

10. Yoo H.W., Jin H.Y., Yon D.K. et al. Non-alcoholic Fatty Liver Disease and COVID-19 Susceptibility and Outcomes: a Korean Nationwide Cohort. J Korean Med Sci. 2021;36(41): e291. doi: 10.3346/jkms.2021.36.e291.

11. Younossi Z.M., Koenig A.B., Abdelatif D. et al. Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology. 2016;64(1):73-84. doi: 10.1002/hep.28431.

12. Younossi Z.M., Marchesini G., Pinto-Cortez H., Petta S. Epidemiology of Nonalcoholic Fatty Liver Disease and Nonalcoholic Steatohepatitis: Implications for Liver Transplantation. Transplantation. 2019;103(1):22-27. doi: 10.1097/TP.0000000000002484.

13. Jagirdhar G.S.K., Pattnaik H., Banga A., Qasba RK. et al. Association of Non-Alcoholic Fatty Liver Disease and Metabolic-Associated Fatty Liver Disease with COVID-19-Related Intensive Care Unit Outcomes: A Systematic Review and Meta-Analysis. Medicina (Kaunas). 2023;59(7):1239. doi: 10.3390/medicina59071239.

14. Hashemi N., Viveiros K., Redd WD. et al. Impact of chronic liver disease on outcomes of hospitalized patients with COVID-19: A multicentre United States experience. Liver Int. 2020;40(10):2515-2521. doi: 10.1111/liv.14583.

15. Huang Сh., Wang Y., Li X., Ren L. et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet. 2020;395(10223):497-506. doi: 10.1016/s0140-6736(20).30183-5.

16. Li J., Huang D.Q., Zou B. et al. Epidemiology of COVID-19: A systematic review and meta-analysis of clinical characteristics, risk factors, and outcomes. J Med Virol. 2021;93(3):1449-1458. doi: 10.1002/jmv.26424.

17. Srikanth S., Garg V., Subramanian L., Verma J. et al. In-hospital outcomes in COVID-19 patients with non-alcoholic fatty liver disease by severity of obesity: Insights from national inpatient sample 2020. World J Hepatol. 2024;16(6):912-919. doi: 10.4254/wjh.v16.i6.912.

18. Wang H., Mehal W., Nagy L.E., Rotman Y. Immunological mechanisms and therapeutic targets of fatty liver diseases. Cell Mol Immunol. 2021;18(1):73-91. doi: 10.1038/s41423-020-00579-3.

19. Fan Z., Chen L., Li J. et al. Clinical Features of COVID-19-Related Liver Functional Abnormality. Clin Gastroenterol Hepatol. 2020;18(7):1561-1566. doi: 10.1016/j.cgh.2020.04.002.

20. Zhang J.J., Cao Y.Y., Tan G. et al. Clinical, radiological, and laboratory characteristics and risk factors for severity and mortality of 289 hospitalized COVID-19 patients. Allergy. 2021;76(2):533-550. doi: 10.1111/all.14496.

21. Xu L., Liu J., Lu M. et al. Liver injury during highly pathogenic human coronavirus infections. Liver Int. 2020;40(5):998-1004. doi: 10.1111/liv.14435.

22. Ilchenko L. Yu., Nikitin I.G., Fedorov I.G. COVID-19 and liver damage. Archive of Internal Medicine. 2020;10(3): 188-197. (In Russ.) doi: 10.20514/2226-6704-2020-10-3-188-197.@@ Ильченко Л.Ю., Никитин И.Г., Федоров И.Г. COVID-19 и поражение печени. Архивъ внутренней медицины. 2020;10(3): 188-197. doi: 10.20514/2226-6704-2020-10-3-188-197.

23. Zou X., Chen K., Zou J. et al. Single-cell RNA-seq data analysis on the receptor ACE2 expression reveals the potential risk of different human organs vulnerable to 2019-nCoV infection. Front Med. 2020;14(2):185-192. doi: 10.1007/s11684-020-0754-0.

24. Xu Z., Shi L., Wang Y.et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med. 2020;8(4):420-422. doi: 10.1016/S2213-2600(20)30076-X.

25. Chen Z., Yu R., Xiong Y. et al. A vicious circle between insulin resistance and inflammation in nonalcoholic fatty liver disease. Lipids Health Dis. 2017;16(1):203. doi: 10.1186/s12944-017-0572-9.

26. Medetalibeyoglu A., Catma Y., Senkal N. et al. The effect of liver test abnormalities on the prognosis of COVID-19. Ann Hepatol. 2020;19(6):614-621. doi: 10.1016/j.aohep.2020.08.068.

27. Adolph T.E., Grander C., Grabherr F., Tilg H. Adipokines and Non-Alcoholic Fatty Liver Disease: Multiple Interactions.Int J Mol Sci. 2017;18(8):1649. doi: 10.3390/ijms18081649.

28. Herta T., Berg T. COVID-19 and the liver - Lessons learned. Liver Int. 2021;41 Suppl 1(Suppl 1):1-8. doi: 10.1111/liv.14854.

29. Bessone F., Razori M.V., Roma M.G. Molecular pathways of nonalcoholic fatty liver disease development and progression. Cell Mol Life Sci. 2019;76(1):99-128. doi: 10.1007/s00018-018-2947-0.

30. Dietrich C.G., Geier A., Merle U. Non-alcoholic fatty liver disease and COVID-19: Harmless companions or disease intensifier? World J Gastroenterol. 2023;29(2):367-377. doi: 10.3748/wjg.v29.i2.367.

31. Wang H., Mehal W., Nagy L.E., Rotman Y. Immunological mechanisms and therapeutic targets of fatty liver diseases. Cell Mol Immunol. 2021;18(1):73-91. doi: 10.1038/s41423-020-00579-3.

32. Cai Q., Huang D., Yu H. et al. COVID-19: Abnormal liver function tests. J Hepatol. 2020;73(3):566-574. doi: 10.1016/j.jhep.2020.04.006.

33. Chen H., Chen Q. COVID-19 Pandemic: Insights into Interactions between SARS-CoV-2 Infection and MAFLD.Int J Biol Sci. 2022;18(12):4756-4767. doi: 10.7150/ijbs.72461.

34. Dietrich C.G., Geier A., Merle U. Non-alcoholic fatty liver disease and COVID-19: Harmless companions or disease intensifier? World J Gastroenterol. 2023;29(2):367-377. doi: 10.3748/wjg.v29.i2.367.

35. Zhang J.J., Cao Y.Y., Tan G. et al. Clinical, radiological, and laboratory characteristics and risk factors for severity and mortality of 289 hospitalized COVID-19 patients. Allergy. 2021;76(2):533-550. doi: 10.1111/all.14496.

36. Herta T., Berg T. COVID-19 and the liver - Lessons learned. Liver Int. 2021;41 Suppl 1(Suppl 1):1-8. doi: 10.1111/liv.14854.

37. Medetalibeyoglu A., Catma Y., Senkal N. et al. The effect of liver test abnormalities on the prognosis of COVID-19. Ann Hepatol. 2020;19(6):614-621. doi: 10.1016/j.aohep.2020.08.068.

38. Alieva S.A., Nikitin I.G. Non-alcoholic fatty liver disease as a predictor of unfavorable course of COVID-19. Medical business. 2022; 2:50-55. (In Russ.) doi: 10.24412/2071-5315-2022-12806.@@ Алиева С.А., Никитин И.Г. Неалкогольная жировая болезнь печени как предиктор неблагоприятного течения COVID-19. Лечебное дело. 2022; 2:50-55. doi: 10.24412/2071-5315-2022-12806


Review

For citations:


Alieva S.A., Nikitin I.G., Vasilyeva I.V. Clinical features of COVID-19 in hospitalized patients with non-alcoholic fatty liver disease. Experimental and Clinical Gastroenterology. 2025;(2):52-61. (In Russ.) https://doi.org/10.31146/1682-8658-ecg-234-2-52-61

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