Metabolic associated fatty liver disease is highly prevalent in the post-acute COVID syndrome

ABSTRACT

Background and Aims: Recently a proposal has been advanced to change the traditional definition of Non-Alcoholic 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 COVID is a smoldering inflammatory condition, characterized by a number of symptom clusters. This study aims to determine the prevalence of MAFLD in patients with post-acute COVID syndrome (PACS) and its association with other PACS-cluster phenotypes. Method(s) We included 235 patients followed at a single university outpatient clinic. The diagnosis of PACS was based on >=1 cluster of symptoms respiratory, neurocognitive, musculoskeletal, psychological, sensory, dermatological. The outcome was prevalence of MAFLD detected by transient elastography during the first post-discharge follow-up outpatient visit. The prevalence of MAFLD at the time of hospital admission was calculated retrospectively using the hepatic steatosis index. Result(s) 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<0.001). Insulin resistance (OR=1.5, 95%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 0.76-0.97). Thirty-one patients (13.2%) had MAFLD with no other associated PACS clusters. All correlations between MAFLD and other PACS clusters were weak. Conclusion(s) MAFLD was highly prevalent after hospital discharge and may represent a specific PACS-cluster phenotype, with potential long-term metabolic and cardiovascular health implications. Copyright © 2022