Non-alcoholic fatty liver disease and clinical outcomes in patients with COVID-19: A comprehensive systematic review and meta-analysis

Non-alcoholic fatty liver disease and clinical outcomes in patients with COVID-19: A comprehensive systematic review and meta-analysis

Non-alcoholic fatty liver disease (NAFLD) patients represent a vulnerable population that may be susceptible to more severe COVID-19. Moreover, not only the underlying NAFLD may influence the progression of COVID-19, but the COVID-19 may affect the clinical course of NAFLD as well. However, comprehe...

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Veröffentlicht in:Diabetes & metabolic syndrome clinical research & reviews 2021-05, Vol.15 (3), p.813-822
Hauptverfasser: Singh, Ambrish, Hussain, Salman, Antony, Benny
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COVID-19
Mortality
NAFLD
Severity
Systematic review
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Hussain, Salman
Antony, Benny
description Non-alcoholic fatty liver disease (NAFLD) patients represent a vulnerable population that may be susceptible to more severe COVID-19. Moreover, not only the underlying NAFLD may influence the progression of COVID-19, but the COVID-19 may affect the clinical course of NAFLD as well. However, comprehensive evidence on clinical outcomes in patients with NAFLD is not well characterized. To systematically review and meta-analysis the evidence on clinical outcomes in NAFLD patients with COVID-19. MEDLINE, EMBASE, and Cochrane Central were searched from inception through November 2020. Epidemiological studies assessing the clinical outcomes in COVID-19 patients with NAFLD were included. Newcastle-Ottawa Scale (NOS) was used to assess study quality. Generic inverse variance method using RevMan was used to determine the pooled estimates using the random-effects model. Fourteen studies consisting of 1851 NAFLD patients, were included. Significant heterogeneity was observed among the studies, and studies were of moderate to high quality [mean, (range):8 (6, 8)]. For NAFLD patients, the adjusted odds ratio (aOR) for the severe COVID-19 was 2.60 (95%CI:2.24–3.02; p 
doi_str_mv 10.1016/j.dsx.2021.03.019
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Moreover, not only the underlying NAFLD may influence the progression of COVID-19, but the COVID-19 may affect the clinical course of NAFLD as well. However, comprehensive evidence on clinical outcomes in patients with NAFLD is not well characterized. To systematically review and meta-analysis the evidence on clinical outcomes in NAFLD patients with COVID-19. MEDLINE, EMBASE, and Cochrane Central were searched from inception through November 2020. Epidemiological studies assessing the clinical outcomes in COVID-19 patients with NAFLD were included. Newcastle-Ottawa Scale (NOS) was used to assess study quality. Generic inverse variance method using RevMan was used to determine the pooled estimates using the random-effects model. Fourteen studies consisting of 1851 NAFLD patients, were included. Significant heterogeneity was observed among the studies, and studies were of moderate to high quality [mean, (range):8 (6, 8)]. For NAFLD patients, the adjusted odds ratio (aOR) for the severe COVID-19 was 2.60 (95%CI:2.24–3.02; p &lt; 0.001) (studies,n:8), aOR for admission to ICU due to COVID-19 was 1.66 (95%CI:1.26–2.20; p &lt; 0.001) (studies,n:2), and aOR for mortality for was 1.01 (95%CI:0.65–1.58; p = 0.96) (studies,n:2). An increased risk of severe COVID-19 infection and admission to ICU due to COVID-19 with no difference in mortality was observed between NAFLD and non-NAFLD patients. Future studies should include the mortality outcome to conclusively elucidate the impact of NAFLD in patients with COVID-19. •An increased risk of severe COVID-19 infection and admission to ICU in NAFLD patient.•No difference in mortality due to COVID-19 was observed between NAFLD and non-NAFLD patients.•Future studies should include the mortality outcome to understand the impact of NAFLD in COVID-19 patients.</description><identifier>ISSN: 1871-4021</identifier><identifier>EISSN: 1878-0334</identifier><identifier>DOI: 10.1016/j.dsx.2021.03.019</identifier><identifier>PMID: 33862417</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>COVID-19 ; Mortality ; NAFLD ; Severity ; Systematic review</subject><ispartof>Diabetes &amp; metabolic syndrome clinical research &amp; reviews, 2021-05, Vol.15 (3), p.813-822</ispartof><rights>2021 Diabetes India</rights><rights>Copyright © 2021 Diabetes India. Published by Elsevier Ltd. 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Moreover, not only the underlying NAFLD may influence the progression of COVID-19, but the COVID-19 may affect the clinical course of NAFLD as well. However, comprehensive evidence on clinical outcomes in patients with NAFLD is not well characterized. To systematically review and meta-analysis the evidence on clinical outcomes in NAFLD patients with COVID-19. MEDLINE, EMBASE, and Cochrane Central were searched from inception through November 2020. Epidemiological studies assessing the clinical outcomes in COVID-19 patients with NAFLD were included. Newcastle-Ottawa Scale (NOS) was used to assess study quality. Generic inverse variance method using RevMan was used to determine the pooled estimates using the random-effects model. Fourteen studies consisting of 1851 NAFLD patients, were included. Significant heterogeneity was observed among the studies, and studies were of moderate to high quality [mean, (range):8 (6, 8)]. 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Future studies should include the mortality outcome to conclusively elucidate the impact of NAFLD in patients with COVID-19. •An increased risk of severe COVID-19 infection and admission to ICU in NAFLD patient.•No difference in mortality due to COVID-19 was observed between NAFLD and non-NAFLD patients.•Future studies should include the mortality outcome to understand the impact of NAFLD in COVID-19 patients.</description><subject>COVID-19</subject><subject>Mortality</subject><subject>NAFLD</subject><subject>Severity</subject><subject>Systematic review</subject><issn>1871-4021</issn><issn>1878-0334</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9kc9u1DAQhyMEon_gAbggH7kk2HESOyAhVQuFShW9AFfLOx6zXjnxYnu37Avw3Li7pYILJ1ua33wzmq-qXjDaMMqG1-vGpJ9NS1vWUN5QNj6qTpkUsqacd48Pf1Z3pXxSnaW0prTvx3Z8Wp1wLoe2Y-K0-vU5zLX2EFbBOyBW57wn3u0wEuMS6oREz4aAd7MD7UnYZggTJuJmstHZ4ZwTuXV5RRY3367e12x8Qy5IiWwirnBOhUTSPmWcShhIxJ3D2wNywqxrPWu_Ty49q55Y7RM-v3_Pq6-XH74sPtXXNx-vFhfXNXQ9y7XkS7RLC0smWpCjtmYAISxoqgchWC-51RwMF90AFsauH60UoxUjpUYIKfh59e7I3WyXExoo60ft1Sa6Sce9CtqpfyuzW6nvYackZYxTWQCv7gEx_NhiympyCdB7PWPYJtX2rEyV8jCLHaMQQ0oR7cMYRtWdP7VWxZ-686coV8Vf6Xn5934PHX-ElcDbYwDLlcoto0pQJAAaFxGyMsH9B_8b9RKvBw</recordid><startdate>20210501</startdate><enddate>20210501</enddate><creator>Singh, Ambrish</creator><creator>Hussain, Salman</creator><creator>Antony, Benny</creator><general>Elsevier Ltd</general><general>Diabetes India. 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subjects COVID-19
Mortality
NAFLD
Severity
Systematic review
title Non-alcoholic fatty liver disease and clinical outcomes in patients with COVID-19: A comprehensive systematic review and meta-analysis
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