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The Association of Metabolic-Associated Fatty Liver Disease with Clinical Outcomes of COVID-19: A Systematic Review

Umar Hayat1, Muhammad Zubair Ashfaq2, Luke Johnson1

  • 1Department of Internal Medicine, University of Kansas School of Medicine-Wichita, Wichita, KS.

Kansas Journal of Medicine
|July 28, 2022
PubMed
Abstract

Insights

Metabolic-associated fatty liver disease (MAFLD) increases COVID-19 severity and ICU admission risk. While MAFLD is common in COVID-19 patients, its link to mortality was not significant in this meta-analysis.

Area of Science:

  • Hepatology
  • Infectious Diseases
  • Metabolic Syndrome

Background:

  • Metabolic-associated fatty liver disease (MAFLD) is a liver manifestation of metabolic syndrome (MS).
  • MAFLD is increasingly recognized as a risk factor for severe COVID-19 outcomes.
  • Existing evidence linking MAFLD to COVID-19 outcomes requires comprehensive characterization.

Purpose of the Study:

  • To conduct a meta-analysis determining clinical outcomes of COVID-19 in patients with MAFLD compared to those without.
  • To quantify the prevalence of MAFLD among COVID-19 patients.
  • To assess the association between MAFLD and COVID-19 severity, ICU admission, and mortality.

Main Methods:

  • A systematic literature search was performed across CINAHL, PubMed/Medline, and Embase.
  • Included studies reported MAFLD prevalence in COVID-19 patients and compared clinical outcomes.
  • Pooled prevalence and odds ratios (OR) with 95% confidence intervals (CI) were calculated for MAFLD and COVID-19 outcomes.

Main Results:

  • Sixteen observational studies with 11,484 participants (1,746 with MAFLD) were included.
  • The pooled prevalence of MAFLD among COVID-19 patients was 29% (95% CI: 19%-40%).
  • MAFLD was significantly associated with increased COVID-19 disease severity (OR 3.07) and ICU admission (OR 1.46).
  • The association between MAFLD and COVID-19 mortality was not statistically significant (OR 1.45).

Conclusions:

  • A substantial proportion of COVID-19 patients exhibit MAFLD.
  • MAFLD is linked to a higher risk of severe COVID-19 disease and intensive care unit admission.
  • Further research may clarify the non-significant association with mortality.
Keywords:
SARS-CoV-2critical illnessmeta-analysisnon-alcoholic fatty liver diseasestatistical data analysis

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