Metabolic-Associated Fatty Liver Disease Is Highly Prevalent in the Postacute COVID Syndrome

Jovana Milic, Sara Barbieri,Licia Gozzi, Alberto Brigo,Bianca Beghé, Alessia Verduri,Erica Bacca, Vittorio Iadisernia, Gianluca Cuomo,Giovanni Dolci, Dina Yaacoub,Emanuele Aprile,Michela Belli, Maria Venuta,Marianna Meschiari,Giada Sebastiani,Enrico Clini, Cristina Mussini,Amedeo Lonardo,Giovanni Guaraldi,Paolo Raggi大牛学者


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Background A proposal has recently been advanced to change the traditional definition of nonalcoholic fatty liver disease to metabolic-associated fatty liver disease (MAFLD), to reflect the cluster of metabolic abnormalities that may be more closely associated with cardiovascular risk. Long coronavirus disease 2019 (COVID-19) is a smoldering inflammatory condition, characterized by several symptom clusters. This study aims to determine the prevalence of MAFLD in patients with postacute COVID syndrome (PACS) and its association with other PACS-cluster phenotypes. Methods We included 235 patients observed at a single university outpatient clinic. The diagnosis of PACS was based on >= 1 cluster of symptoms: respiratory, neurocognitive, musculoskeletal, psychological, sensory, and dermatological. The outcome was prevalence of MAFLD detected by transient elastography during the first postdischarge follow-up outpatient visit. The prevalence of MAFLD at the time of hospital admission was calculated retrospectively using the hepatic steatosis index. Results Of 235 patients, 162 (69%) were men (median age 61). The prevalence of MAFLD was 55.3% at follow-up and 37.3% on admission (P < .001). Insulin resistance (odds ratio [OR] = 1.5; 95% confidence interval [CI], 1.14-1.96), body mass index (OR = 1.14; 95% CI, 1.04-1.24), and the metabolic syndrome (OR = 2.54; 95% CI, 1.13-5.68) were independent predictors of MAFLD. The number of PACS clusters was inversely associated with MAFLD (OR = 0.86; 95% CI, .76-0.97). Thirty-one patients (13.2%) had MAFLD with no other associated PACS clusters. All correlations between MAFLD and other PACS clusters were weak. Conclusions Metabolic-associated fatty liver disease was highly prevalent after hospital discharge and may represent a specific PACS-cluster phenotype, with potential long-term metabolic and cardiovascular health implications. It has been proposed that Non-Alcoholic Fatty Liver Disease should be renamed Metabolic Associated Fatty Liver Disease (MAFLD) with potential long-term cardiovascular complications. MAFLD was highly prevalent after hospital discharge in COVID-19 and may represent a specific PACS-cluster phenotype.
COVID, 19, metabolic-associated fatty liver disease
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