The Association of Metabolic-associated Fatty Liver Disease with Clinical Outcomes of COVID-19: A Systematic Review and Meta-Analysis
MAFLD and COVID-19 clinical outcomes
Keywords:Keywords: Metabolic-associated fatty liver disease; Severe acute respiratory syndrome coronavirus-2; COVID-19; Odds ratios; Meta-analysis; COVID-19 prevalence.
Introduction. Metabolic-associated fatty liver disease (MAFLD) is a hepatic manifestation of metabolic syndrome (MS). MAFLD patients have a higher prevalence of COVID-19. MAFLD is also associated with worse clinical outcomes of COVID-19, such as disease severity, ICU admission rate, and higher mortality rates. However, this evidence has not been well characterized in the literature. This meta-analysis aims to determine the clinical outcomes of COVID-19 among MAFLD patients compared to the non-MAFLD group.
Methods. A comprehensive search was conducted in CINAHL, PubMed/Medline, and Embase for studies reporting MAFLD prevalence among COVID-19 patients and comparing clinical outcomes such as severity, ICU admission, and mortality among patients with and without MAFLD. We calculated the pooled prevalence of MAFLD among COVID-19 patients. Also, the pooled odds ratios (ORs) with 95% confidence interval (CI) were calculated for clinical outcomes of COVID-19.
Results. Twenty observational studies met inclusion criteria involving 13,036 overall study participants, including 2,374 MAFLD patients. The prevalence of COVID-19 among MAFLD patients was 0.28 (95% CI: 0.19-0.39). MAFLD was associated with the COVID-19 disease severity OR: 2.61 (95% CI: 1.77-3.83). Similarly, MAFLD was associated with an increased risk of ICU admission compared to the non-MAFLD group OR: 1.46 (95% CI: 1.12-1.91). Lastly, the association between MAFLD and COVID-19 mortality was not statistically significant OR: 1.25 (95% CI: 0.66-2.37).
Conclusions. There was a higher prevalence of MAFLD among COVID-19 patients than the non-MAFLD group. Moreover, MAFLD patients had an increased risk of COVID-19 disease severity and ICU admission rate.
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Copyright (c) 2022 Umar Hayat, M.D., MPH, Muhammad Zubair Ashfaq, M.D., Luke Johnson, M.D., Ryan Ford, M.D., Chelsea Wuthnow, M.D., Kevin Kadado, M.D., Katia El Jurdi, M.D., Hayrettin Okut, Ph.D., William Ransom Kilgore, M.D., Maha Assi, M.D., Ali A. Siddiqui, M.D.
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