Subject(s)
Betacoronavirus , Coronavirus Infections/complications , Non-alcoholic Fatty Liver Disease/complications , Obesity/complications , Pneumonia, Viral/complications , Adolescent , Adult , Aged , COVID-19 , Female , Humans , Male , Middle Aged , Pandemics , Risk Factors , SARS-CoV-2 , Young AdultABSTRACT
Background and Aim: Circulating levels of interleukin (IL)-6, a well-known inflammatory cytokine, are often elevated in coronavirus disease-2019 (COVID-19). Elevated IL-6 levels are also observed in patients with metabolic dysfunction-associated fatty liver disease (MAFLD). Our study aimed to describe the association between circulating IL-6 levels and MAFLD at hospital admission with risk of severe COVID-19. Methods: A total of 167 patients with laboratory-confirmed COVID-19 from three Chinese hospitals were enrolled. Circulating levels of IL-2, IL-4, IL-6, IL-10, tumor necrosis factor (TNF)-α, and interferon (IFN)-γ were measured at admission. All patients were screened for fatty liver by computed tomography. Forty-six patients were diagnosed as MAFLD. Results: Patients with MAFLD (n = 46) had higher serum IL-6 levels (median 7.1 [interquartile range, 4.3-20.0] vs. 4.8 [2.6-11.6] pg/mL, p = 0.030) compared to their counterparts without MAFLD (n = 121). After adjustment for age and sex, patients with MAFLD had a ~2.6-fold higher risk of having severe COVID-19 than those without MAFLD. After adjustment for age, sex and metabolic co-morbidities, increased serum IL-6 levels remained associated with higher risk of severe COVID-19, especially among infected patients with MAFLD (adjusted-odds ratio 1.14, 95% CI 1.05-1.23; p = 0.002). There was a significant interaction effect between serum IL-6 levels and MAFLD for risk of severe COVID-19 (p for interaction = 0.008). Conclusions: Patients with MAFLD and elevated serum IL-6 levels at admission are at higher risk for severe illness from COVID-19.
Subject(s)
COVID-19/complications , Fatty Liver/epidemiology , Interleukin-6/blood , Metabolic Diseases/physiopathology , SARS-CoV-2/isolation & purification , Severity of Illness Index , Adolescent , Adult , Aged , COVID-19/transmission , COVID-19/virology , China/epidemiology , Fatty Liver/blood , Fatty Liver/pathology , Fatty Liver/virology , Female , Humans , Male , Middle Aged , Retrospective Studies , Risk Factors , Young AdultSubject(s)
Acute Kidney Injury , Coronavirus Infections , Kidney Failure, Chronic , Pandemics , Pneumonia, Viral , Betacoronavirus , COVID-19 , Humans , Retrospective Studies , SARS-CoV-2ABSTRACT
The Corona Virus Disease 2019 (COVID-19) pandemic has attracted increasing worldwide attention. While metabolic-associated fatty liver disease (MAFLD) affects a quarter of world population, its impact on COVID-19 severity has not been characterized. We identified 55 MAFLD patients with COVID-19, who were 1:1 matched by age, sex and obesity status to non-aged severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected patients without MAFLD. Our results demonstrate that in patients aged less than 60 years with COVID-19, MAFLD is associated with an approximately fourfold increase (adjusted odds ratio 4.07, 95% confidence interval 1.20-13.79, P = .02) in the probability for severe disease, after adjusting for confounders. Healthcare professionals caring for patients with COVID-19 need to be aware that there is a positive association between MAFLD and severe illness with COVID-19.