Letter to the Editor: Obesity as a risk factor for greater severity of COVID 19 in patients with metabolic associated fatty liver disease
Abstract Background Aims. Coronavirus disease 2019 (COVID 19) has been declared a pandemic in 2020. Patients with metabolic associated fatty liver disease (MAFLD) are often obese and have additional metabolic risk factors which may aggravate the severity of respiratory diseases and of COVID 19. This study aims to investigate the association between MAFLD and COVID 19 severity. Methods 214 patients with laboratory confirmed COVID 19 aged between 18 and 75 years from three hospitals in Wenzhou, China were consecutively enrolled. Sixty six patients with MAFLD were included in the final analysis. COVID 19 was diagnosed as a positive result by high throughput sequencing or real time reverse transcriptase polymerase chain reaction assay of oropharyngeal swab specimens. COVID 19 severity was assessed during hospitalization and classified as severe and non severe based on the current management guideline. All patients were screened for fatty liver by computed tomography and subsequently diagnosed as MAFLD according to a recent set of consensus diagnostic criteria. Obesity was defined as BMI >25 kg/m2. Results The presence of obesity in MAFLD patients was associated with a 6 fold increased risk of severe COVID 19 illness (unadjusted OR 5.77, 95% CI 1.19 27.91, p .029) Notably, this association with obesity and COVID 19 severity remained significant (adjusted OR 6.32, 95% CI 1.16 34.54, p .033) even after adjusting for age, sex, smoking, diabetes, hypertension, and dyslipidaemia. Conclusions Our data demonstrate that the risk of obesity to COVID 19 severity is greater in those with, than those without MAFLD.
Metabolism