Liver fibrosis worsens COVID-19 outcomes

In patients with metabolic dysfunction-associated fatty liver disease (MAFLD), liver fibrosis seems to worsen outcomes of the novel coronavirus disease (COVID-19), increasing the risk of mechanical ventilation, acute kidney injury, and death, a recent study has found.

The researchers conducted a retrospective cohort analysis of 432 hospitalized COVID-19 patients. The presence of liver fibrosis was determined in a two-step approach: computed tomography (CT) to detect liver steatosis, followed by a calculation of the nonalcoholic fatty liver disease fibrosis score.

Most (n=256; mean age 52±14 years, 61.2 percent men) of the participants did not have MAFLD, while the remaining 176 (mean age 48±12 years, 69.5 percent men) did. Both groups had no significant differences in terms of COVID-19 outcomes, showing comparable levels of pulmonary involvement on CT scan and receiving similar treatments.

Logistic regression analysis revealed that in COVID-19 patients with MAFLD, fibrosis increased the risk of endotracheal intubation by over three times (odds ratio [OR], 3.243, 95 percent confidence interval [CI], 1.355–7.760; p=0.008) and of acute kidney injury by more than two times (OR, 2.511, 95 percent CI, 1.000–6.304; p=0.05).

Moreover, fibrosis was also significantly correlated with the risk of mortality (hazard ratio, 2.543, 95 percent CI, 1.147–5.637; p=0.022).

“[T]he presence of fibrosis, rather than the presence of MAFLD, has an impact on the risk of mechanical ventilation requirement, development of acute kidney injury, and higher mortality in patients with COVID-19,” the researchers said.