Evidence based observations suggest that COVID-19 can cause liver injury. Although, few studies evaluated liver injury in patients with COVID-19 with chronic liver diseases, present study reviewed clinical features in patients with COVID-19 with nonalcoholic fatty liver disease (NAFLD).

The present study recruited confirmed patients with COVID-19 between January 18, 2020, and February 26, 2020. NAFLD was defined by hepatic steatosis index (HSI). A total of 280 patients with COVID-19 were enrolled. Among 280 patients with COVID-19, 86 (30.7%) were diagnosed as NAFLD by HSI.

The results of the study revealed abnormal liver function was seen in 35.7% patients on admission. The median alanine aminotransferase (ALT) levels (34.5 U/L vs. 23.0 U/L) and the proportion of elevated ALT (>40 U/L) (40.7% vs. 10.8%) were considerably higher in patients with NAFLD in contrast to patients without NAFLD on admission. The proportion of elevated ALT in patients with NAFLD was also substantially higher in comparison to patients without NAFLD (65.1% vs. 38.7%) during hospitalization. The independent risk factors of ALT elevation in patients with COVID-19 were age over 50 years (odds ratio [OR], 2.077; 95% confidence interval [CI], 1.183, 3.648) and concurrent NAFLD (OR, 2.956; 95% CI, 1.526, 5.726). Moreover, the atomized inhalation of interferon α-2b (OR, 0.402; 95% CI, 0.236, 0.683) was correlated with reduced risk of ALT elevation during hospitalization. None of the patient developed liver failure or death during hospitalization. However, the complications and clinical outcomes were similar between patients with COVID-19 with and without NAFLD.

Thus, it can be concluded that patients with NAFLD coinfected with COVID-19 are more susceptible to have liver injury. Nevertheless, present study showed that none of the recruited patient developed life-threatening liver-related complications during hospitalization.

Source: Huang R, Zhu L, Wang J, Xue L, Liu L, Yan X, Huang S, Li Y, Yan X, Zhang B, Xu T, Li C, Ji F, Ming F, Zhao Y, Cheng J, Wang Y, Zhao H, Hong S, Chen K, Zhao XA, Zou L, Sang D, Shao H, Guan X, Chen X, Chen Y, Wei J, Zhu C, Wu C. Clinical features of COVID-19 patients with non-alcoholic fatty liver disease. Hepatol Commun. 2020 Aug 6;4(12):1758–68.