PDF(Pubmed)
Abstract：
It is important to identify risk factors for poor outcomes of coronavirus disease 2019 (COVID-19) patients. Currently, the correlation between non-alcoholic fatty liver disease (NAFLD) and COVID-19 outcomes has not been established. This study was conducted to determine the association between NAFLD and in-hospital outcomes of COVID-19 patients. The systematic searches were conducted by using PubMed and the Europe PMC databases and particular keywords were used as of December 10, 2020. Further searches were conducted up to 2022. All articles that include data about COVID-19 and fatty liver disease were collected. Statistical analysis was performed by using Review Manager 5.4 and Comprehensive Meta-Analysis version 3 software. A total of 7,210 COVID-19 patients from 18 studies were included in the final analysis. Meta-analysis revealed that NAFLD increased the risk of developing poor in-hospital outcome (pooled both severe disease and death) in COVID-19 patients (RR 1.42; 95%CI: 1.17-1.73, p<0.001, I2=84%, random-effect modeling). Subgroup analysis however found that having NAFLD only increased the chance of getting severe COVID-19 (RR 1.67; 95%CI: 1.32-2.13, p<0.001, I2=86%, random-effect modeling) and not mortality (RR 1.00; 95%CI: 0.68-1.47, p=0.98, I2=80%, random-effect modeling). Meta-regression suggested that age (p=0.001) and diabetes (p=0.029) were significantly influenced the relationship between NAFLD and in-hospital outcomes of COVID-19 (pooled both severe disease and mortality). The weaker association of NAFLD and in-hospital outcomes of COVID-19 was found for studies with median age ≥45 years old (RR 1.29) when compared to studies with median age <45 years old (RR 2.96). In addition, studies with the prevalence of diabetes ≥25% (RR 1.29) had a weaker association with in-hospital outcomes when compared to studies with diabetes prevalence <25% (RR 1.85). In conclusion, NAFLD increased the risk of chance of getting severe COVID-19 and therefore it should be evaluated closely to reduce the chance of getting severe COVID-19.
摘要：
重要的是要确定2019年冠状病毒病（COVID-19）患者预后不良的危险因素。目前,非酒精性脂肪性肝病(NAFLD)与COVID-19结局之间的相关性尚未确定.这项研究旨在确定NAFLD与COVID-19患者住院结局之间的关系。系统搜索是通过使用PubMed和欧洲PMC数据库进行的，截至2020年12月10日，使用了特定的关键词。直到2022年才进行了进一步的搜索。收集了所有包括COVID-19和脂肪肝数据的文章。采用ReviewManager5.4和综合Meta分析3版软件进行统计分析。来自18项研究的7210名COVID-19患者被纳入最终分析。荟萃分析显示，NAFLD增加了COVID-19患者院内预后不良（合并严重疾病和死亡）的风险（RR1.42;95CI：1.17-1.73，p<0.001，I2=84％，随机效应建模)。然而，亚组分析发现，患有NAFLD只会增加患重度COVID-19的机会(RR1.67;95CI:1.32-2.13，p<0.001，I2=86%，随机效应建模)，而不是死亡率(RR1.00；95CI：0.68-1.47，p=0.98，I2=80%，随机效应建模)。Meta回归显示，年龄(p=0.001)和糖尿病(p=0.029)显著影响NAFLD与COVID-19的住院结局(合并严重疾病和死亡率)之间的关系。与中位年龄<45岁（RR2.96）的研究相比，中位年龄≥45岁（RR1.29）的研究发现NAFLD与COVID-19的住院结局的相关性较弱。此外,与糖尿病患病率<25%(RR1.85)的研究相比,糖尿病患病率≥25%(RR1.29)的研究与院内结局的相关性较弱.总之,NAFLD增加了患严重COVID-19的风险，因此应密切评估以减少患严重COVID-19的机会。
