Hegyi Péter Jenő, Váncsa Szilárd, Ocskay Klementina, Dembrovszky Fanni, Kiss Szabolcs, Farkas Nelli, Erőss Bálint, Szakács Zsolt, Hegyi Péter, Pár Gabriella
Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary.
Szentágothai Research Center, University of Pécs, Pécs, Hungary.
Front Med (Lausanne). 2021 Mar 12;8:626425. doi: 10.3389/fmed.2021.626425. eCollection 2021.
The most common pre-existing liver disease, the metabolic dysfunction-associated fatty liver disease (MAFLD) formerly named as non-alcoholic fatty liver disease (NAFLD), may have a negative impact on the severity of COVID-19. This meta-analysis aimed to evaluate if MAFLD or NAFLD are associated with a more severe disease course of COVID-19. A systematic search was performed in five databases for studies comparing severity, the rate of intensive care unit (ICU) admission, and mortality of COVID-19 patients with and without MAFLD or NAFLD. In meta-analysis, pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Altogether, we included nine studies in our quantitative and qualitative synthesis. MAFLD was associated with an increased risk of severe COVID-19 compared to the non-MAFLD group (28 vs. 13%, respectively; OR = 2.61, CI: 1.75-3.91). Similarly, in the NAFLD vs. non-NAFLD comparison, NAFLD proved to be a risk factor as well (36 vs. 12%, respectively; OR = 5.22, CI: 1.94-14.03). On the other hand, NAFLD was not associated with an increased risk of ICU admission (24 vs. 7%, respectively; OR = 2.29, CI: 0.79-6.63). We were unable to perform meta-analysis to investigate the association of MAFLD with the rate of ICU admission and with mortality. In conclusion, patients with MAFLD and NAFLD showed a more severe clinical picture in COVID-19. Our results support the importance of close monitoring of COVID-19 patients with MAFLD. Further research is needed to explore the cause of increased severity of COVID-19 in MAFLD.
最常见的基础肝病，即先前称为非酒精性脂肪性肝病（NAFLD）的代谢功能障碍相关脂肪性肝病（MAFLD），可能会对新冠病毒病（COVID-19）的严重程度产生负面影响。这项荟萃分析旨在评估MAFLD或NAFLD是否与COVID-19更严重的病程相关。我们在五个数据库中进行了系统检索，以查找比较有或没有MAFLD或NAFLD的COVID-19患者的严重程度、重症监护病房（ICU）入住率和死亡率的研究。在荟萃分析中，计算了具有95%置信区间（CI）的合并比值比（OR）。总之，我们在定量和定性综合分析中纳入了9项研究。与非MAFLD组相比，MAFLD与COVID-19重症风险增加相关（分别为28%和13%；OR = 2.61，CI：1.75 - 3.91）。同样，在NAFLD与非NAFLD的比较中，NAFLD也被证明是一个风险因素（分别为36%和12%；OR = 5.22，CI：1.94 - 14.03）。另一方面，NAFLD与ICU入住风险增加无关（分别为24%和7%；OR = 2.29，CI：0.79 - 6.63）。我们无法进行荟萃分析来研究MAFLD与ICU入住率及死亡率之间的关联。总之，MAFLD和NAFLD患者在COVID-19中表现出更严重的临床症状。我们的结果支持密切监测MAFLD合并COVID-19患者的重要性。需要进一步研究以探索MAFLD中COVID-19严重程度增加的原因。
