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Abstract Details
Obesity as a Risk Factor for Greater Severity of COVID-19 in Patients With Metabolic Associated Fatty Liver Disease
Metabolism. 2020 Apr 19;154244. doi: 10.1016/j.metabol.2020.154244. Online ahead of print.
Kenneth I Zheng 1, Feng Gao 2, Xiao-Bo Wang 3, Qing-Feng Sun 4, Ke-Hua Pan 5, Ting-Yao Wang 6, Hong-Lei Ma 1, Wen-Yue Liu 7, Jacob George 8, Ming-Hua Zheng 9
Author information
1MAFLD Research Center, Department of Hepatology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
2Department of Gastroenterology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
3Department of Critical Care Medicine, Wenzhou Central Hospital, Wenzhou, China.
4Department of Infectious Diseases, Ruian People's Hospital, Wenzhou, China.
5Department of Radiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
6Department of Nephrology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
7Department of Endocrinology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
8Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital and University of Sydney, Sydney, Australia. Electronic address: jacob.george@sydney.edu.au.
9MAFLD Research Center, Department of Hepatology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China; Institute of Hepatology, Wenzhou Medical University, Wenzhou, China; Key Laboratory of Diagnosis and Treatment for The Development of Chronic Liver Disease in Zhejiang Province, Wenzhou, China. Electronic address: zhengmh@wmu.edu.cn.
Abstract
Background & aims:Coronavirus disease 2019 (COVID-19) has been declared a pandemic in 2020. Patients with metabolic associated fatty liver disease (MAFLD) are often obese and have additional metabolic risk factors which may aggravate the severity of respiratory diseases and of COVID-19. This study aims to investigate the association between MAFLD and COVID-19 severity.
Methods:214 patients with laboratory-confirmed COVID-19 aged between 18 and 75 years from three hospitals in Wenzhou, China were consecutively enrolled. Sixty-six patients with MAFLD were included in the final analysis. COVID-19 was diagnosed as a positive result by high-throughput sequencing or real-time reverse transcriptase-polymerase chain reaction assay of oropharyngeal swab specimens. COVID-19 severity was assessed during hospitalization and classified as severe and non-severe based on the current management guideline. All patients were screened for fatty liver by computed tomography and subsequently diagnosed as MAFLD according to a recent set of consensus diagnostic criteria. Obesity was defined as BMI >25 kg/m2.
Results:The presence of obesity in MAFLD patients was associated with a ~ 6-fold increased risk of severe COVID-19 illness (unadjusted-OR 5.77, 95% CI 1.19-27.91, p = .029). Notably, this association with obesity and COVID-19 severity remained significant (adjusted-OR 6.32, 95% CI 1.16-34.54, p = .033) even after adjusting for age, sex, smoking, diabetes, hypertension, and dyslipidaemia.