Risk of severe illness of COVID‐19 patients with NAFLD and increased NAFLD fibrosis scores

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Background

There is still little knowledge about the association of liver fibrosis with the clinical outcomes of COVID‐19 patients with non‐alcoholic fatty liver disease (NAFLD). The aim of the study was to determine the association of NAFLD fibrosis score (NFS)–determined liver fibrosis with clinical outcomes of COVID‐19 patients with NAFLD.

Methods

The NAFLD was diagnosed by the Hepatic Steatosis Index (HSI) in the absence of other causes of chronic liver diseases. NFS was used to evaluate the severity of liver fibrosis.

Results

A total of 86 COVID‐19 patients with NAFLD were included. The median age was 43.5 years, and 58.1% of patients were male. Thirty‐eight (44.2%) patients had advanced liver fibrosis according to the NFS. Multivariate analysis indicated that concurrent diabetes (odds ratio [OR] 8.264, 95% confidence interval [CI] 1.202–56.830, p = 0.032) and advanced liver fibrosis (OR 11.057, 95% CI 1.193–102.439, p = 0.034) were independent risk factors of severe illness in COVID‐19 patients with NAFLD.

Conclusion

NAFLD patients with NFS‐determined advanced liver fibrosis are at higher risk of severe COVID‐19.

Abstract

Concurrent with NAFLD is common in COVID‐19 patients. The presence of advanced liver fibrosis was an independent risk factor of severe illness in COVID‐19 patients with NAFLD.

Related collections

Most cited references 30

Record: found
Abstract: found
Article: not found

Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study

Fei Zhou, Ting Yu, Ronghui Du … (2020)

Summary Background Since December, 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics of patients with COVID-19 have been reported but risk factors for mortality and a detailed clinical course of illness, including viral shedding, have not been well described. Methods In this retrospective, multicentre cohort study, we included all adult inpatients (≥18 years old) with laboratory-confirmed COVID-19 from Jinyintan Hospital and Wuhan Pulmonary Hospital (Wuhan, China) who had been discharged or had died by Jan 31, 2020. Demographic, clinical, treatment, and laboratory data, including serial samples for viral RNA detection, were extracted from electronic medical records and compared between survivors and non-survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death. Findings 191 patients (135 from Jinyintan Hospital and 56 from Wuhan Pulmonary Hospital) were included in this study, of whom 137 were discharged and 54 died in hospital. 91 (48%) patients had a comorbidity, with hypertension being the most common (58 [30%] patients), followed by diabetes (36 [19%] patients) and coronary heart disease (15 [8%] patients). Multivariable regression showed increasing odds of in-hospital death associated with older age (odds ratio 1·10, 95% CI 1·03–1·17, per year increase; p=0·0043), higher Sequential Organ Failure Assessment (SOFA) score (5·65, 2·61–12·23; p<0·0001), and d-dimer greater than 1 μg/mL (18·42, 2·64–128·55; p=0·0033) on admission. Median duration of viral shedding was 20·0 days (IQR 17·0–24·0) in survivors, but SARS-CoV-2 was detectable until death in non-survivors. The longest observed duration of viral shedding in survivors was 37 days. Interpretation The potential risk factors of older age, high SOFA score, and d-dimer greater than 1 μg/mL could help clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future. Funding Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences; National Science Grant for Distinguished Young Scholars; National Key Research and Development Program of China; The Beijing Science and Technology Project; and Major Projects of National Science and Technology on New Drug Creation and Development.

0 comments Cited 13485 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: found

Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention

Zunyou Wu, Jennifer M. McGoogan (2020)

0 comments Cited 8389 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: found

Is Open Access

OpenSAFELY: factors associated with COVID-19 death in 17 million patients

Elizabeth J Williamson, Alex J Walker, Krishnan Bhaskaran … (2020)

COVID-19 has rapidly impacted on mortality worldwide. 1 There is unprecedented urgency to understand who is most at risk of severe outcomes, requiring new approaches for timely analysis of large datasets. Working on behalf of NHS England we created OpenSAFELY: a secure health analytics platform covering 40% of all patients in England, holding patient data within the existing data centre of a major primary care electronic health records vendor. Primary care records of 17,278,392 adults were pseudonymously linked to 10,926 COVID-19 related deaths. COVID-19 related death was associated with: being male (hazard ratio 1.59, 95%CI 1.53-1.65); older age and deprivation (both with a strong gradient); diabetes; severe asthma; and various other medical conditions. Compared to people with white ethnicity, black and South Asian people were at higher risk even after adjustment for other factors (HR 1.48, 1.29-1.69 and 1.45, 1.32-1.58 respectively). We have quantified a range of clinical risk factors for COVID-19 related death in the largest cohort study conducted by any country to date. OpenSAFELY is rapidly adding further patients’ records; we will update and extend results regularly.

0 comments Cited 2940 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Contributors

Ming Li: llttyy97@163.com

Rui Huang: doctor_hr@126.com

Chao Wu:

ORCID: https://orcid.org/0000-0002-1657-010X

dr.wu@nju.edu.cn

Journal

Journal ID (nlm-ta): J Clin Lab Anal

Journal ID (iso-abbrev): J Clin Lab Anal

Journal ID (doi): 10.1002/(ISSN)1098-2825

Journal ID (publisher-id): JCLA

Title: Journal of Clinical Laboratory Analysis

Publisher: John Wiley and Sons Inc. (Hoboken )

ISSN (Print): 0887-8013

ISSN (Electronic): 1098-2825

Publication date (Electronic): 02 July 2021

Publication date Collection: August 2021

Volume: 35

Issue: 8 ( doiID: 10.1002/jcla.v35.8 )

Electronic Location Identifier: e23880

Affiliations

[ ¹ ] Department of Infectious Diseases Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University Nanjing China

[ ² ] Department of Infectious Diseases Nanjing Drum Tower Hospital The Affiliated Hospital of Nanjing University Medical School Nanjing China

[ ³ ] Department of Infectious Diseases The Affiliated Infectious Diseases Hospital of Soochow University Suzhou China

[ ⁴ ] Department of Infectious Diseases Nanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western Medicine Nanjing University of Chinese Medicine Nanjing China

[ ⁵ ] Department of Critical Medicine Huai'an No. 4 People's Hospital Huai’an China

[ ⁶ ] Department of Infectious Diseases The Third People's Hospital of Changzhou Changzhou China

[ ⁷ ] Department of Infectious Diseases Affiliated Hospital of Xuzhou Medical University Xuzhou China

[ ⁸ ] Department of Infectious Diseases The People’s Hospital of Suqian Suqian China

[ ⁹ ] Department of Infectious Diseases Yancheng Second People’s Hospital Yancheng China

[ ¹⁰ ] Department of Infectious Diseases Nantong Third People's Hospital Nantong University Nantong China

[ ¹¹ ] Department of Infectious Diseases Taizhou People's Hospital Taizhou China

[ ¹² ] Department of Gastroenterology Northern Jiangsu People’s Hospital Clinical Medical College of Yangzhou University Yangzhou China

[ ¹³ ] Department of Hepatology The Affiliated Infectious Diseases Hospital of Soochow University Suzhou China

Author notes

[*] [* ] Correspondence

Chao Wu, Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, No. 321 Zhongshan Road, Nanjing 210008, Jiangsu, China.

Email: dr.wu@ 123456nju.edu.cn

Rui Huang, Department of Infectious Diseases, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing 210008, Jiangsu, China.

Email: doctor_hr@ 123456126.com

Ming Li, Department of Hepatology, The Affiliated Infectious Disease Hospital of Soochow University, No. 10 Guangqian Road, Suzhou 215000, Jiangsu, China.

Email: llttyy97@ 123456163.com

Author information

Jian Wang https://orcid.org/0000-0001-5004-0877

Chao Wu https://orcid.org/0000-0002-1657-010X

Article

Publisher ID: JCLA23880

DOI: 10.1002/jcla.23880

PMC ID: 8373321

PubMed ID: 34213039

SO-VID: 2163ffe2-16fe-4882-9e15-f6ee6efc56db

License:

This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

History

Date revision received : 01 June 2021

Date received : 29 March 2021

Date accepted : 12 June 2021

Page count

Figures: 1, Tables: 3, Pages: 7, Words: 4436

Funding

Funded by: Yangzhou Key R&D Program (Social Development)

Award ID: YZ2020101

Funded by: the Nanjing Medical Science and Technique Development Foundation

Award ID: QRX17121

Funded by: Fundamental Research Funds for the Central Universities , doi 10.13039/501100012226;

Award ID: 14380459

Funded by: China Postdoctoral Science Foundation for COVID‐19

Award ID: 2020T130049ZX

Custom metadata

source-schema-version-number 2.0

cover-date August 2021

details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_JATSPMC version:6.0.5 mode:remove_FC converted:18.08.2021

ScienceOpen disciplines: Clinical chemistry

Keywords: covid‐19,fibrosis,non‐alcoholic fatty liver disease,severe illness

Data availability:

ScienceOpen disciplines: Clinical chemistry

Keywords: covid‐19, fibrosis, non‐alcoholic fatty liver disease, severe illness