Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has first emerged in December 2019 in China and since then, has spread globally, affecting more than 26.2 million cases and caused over 866,000 deaths as of September 4, 2020. The most critical risk groups for severe clinical presentations includes elderly, with comorbidities such as diabetes, and other chronic conditions (heart and lung disease).

It has been observed that hepatic steatosis including NAFLD and non-alcohol steatohepatitis is associated with visceral adiposity, developed metabolic disease, as well as overt and chronic inflammation process. Similar to interrelationship of pathophysiology of COVID-19 to inflammation, non-alcoholic fatty liver disease and steatohepatitis may also represent remarkable risk factors that increases the risk of poor disease outcomes; however, evaluation for the need of hospitalization in patients with NAFLD coinfected with COVID-19 need further studies.

A retrospective examination of electronic medical records from 56 primary care clinics and 12 hospitals has been done including over 6,700 adults with positive SARS-CoV-2 test results between March 1, 2020, and August 25, 2020. The primary goal of the study was a precise quantification of hospitalization risk for COVID-19 in regard to history of NAFLD and steatohepatitis. In addition, whether the known treatments for metabolic disease could modified this risk, as well as if there any gender or racial differences.

The outcome of the study revealed that the medical history of hepatic steatosis was correlated with increased odds of admission to hospital due to COVID-19. Each additional year of having either non-alcoholic fatty liver disease or steatohepatitis was also associated to a remarkably increased risk of being hospitalized for COVID-19. This increased risk was similar in both men and women, and elevated the same risk within each racial subgroup. The researchers also showed that treatments for metabolic syndrome and NAFLD/NASH greatly alleviated risks from COVID-19. Patients who were on metformin or glucagon-like peptide-1 receptor agonists therapy had a reduced odds of hospitalization, and those who had undergone bariatric surgery had a substantial decrease in odds of hospitalization.

Thus, it can be concluded that individuals with non-alcoholic fatty liver disease (NAFLD) and steatohepatitis have increased odds of hospitalization due to coronavirus disease (COVID-19). On the other hand, the study also documented that metabolic surgery plays a protective role against the admission of infected individuals. Moreover, weight loss is key management approach, and although obesity medicine have shown a sustainable approach, societal forces including the ongoing pandemic continue to foster an obesogenic environment, which requires further research.

Source: Study shows fatty liver disease is a significant risk factor for COVID-19 hospitalization. Available at: https://www.news-medical.net/news/20200903/Study-shows-fatty-liver-disease-is-a-significant-risk-factor-for-COVID-19-hospitalization.aspx. Accessed on: 27-05-21.