More Severe COVID-19 in Patients With Liver Fibrosis

By Reuters Staff

May 26, 2020

NEW YORK (Reuters Health) - Patients with non-alcoholic fatty liver disease (NAFLD) and increased liver-fibrosis scores experience more severe illness from COVID-19, according to a study of Chinese patients.

One recent study found that patients with severe COVID-19 were more likely than patients with nonsevere COVID-19 to have NAFLD. Among patients with NAFLD, the severity of liver fibrosis determines its prognosis.

Dr. Giovanni Targher of the University of Verona, in Italy, and colleagues investigated whether increased noninvasive liver-fibrosis scores - fibrosis-4 (FIB-4) index and NAFLD fibrosis score (NFS) - are associated with an increased risk for severe illness from COVID-19 in 310 patients from Zheijiang Province in China with laboratory-confirmed COVID-19.

Of these patients, 94 had NAFLD, including 44 with low FIB-4, 36 with intermediate FIB-4 and 14 with high FIB-4.

The odds of severe COVID-19 illness were increased 4.32-fold (P<0.001) in patients with intermediate FIB-4 scores and 5.73-fold in patients with high FIB-4 scores (P<0.005), the team reports in Gut.

Intermediate/high NFS was associated with 2.91-fold increased odds of severe COVID-19 illness after controlling for sex, obesity, and diabetes.

Similarly, increasing FIB-4 or NFS as continuous variables were significantly associated with greater COVID-19 severity after adjusting for sex, obesity, diabetes and the presence/absence of NAFLD.

"Further research is needed to better understand the mechanistic link of advanced NAFLD to the viral disease process," the researchers conclude.

Dr. Targher did not respond to a request for comments.

SOURCE: Gut, online May 15, 2020.