CLINICAL AND LABORATORY PREDICTORS OF THE SEVERITY OF COVID-19 INFECTION IN PATIENTS WITH NON-ALCOHOLIC FATTY LIVER DISEASE
Background: The clinical course of COVID-19 infection varied from mild, sometimes asymptomatic manifestations to severe ones, requiring mandatory hospitalization and emergency care, up to the need for artificial pulmonary ventilation (ALV). Increased risk factors for adverse outcomes included older age and comorbid conditions, including non-alcoholic fatty liver disease (NAFLD). Many studies have focused on the severity of COVID-19 in patients with non-alcoholic fatty liver disease (NAFLD) during the pandemic, but few of them fully reflect the clinical features of COVID-19 infection in hospitalized patients with NAFLD.
Aim: Evaluation of the relationship between laboratory parameters and the severity of COVID-19 infection in hospitalized patients with NAFLD.
Materials and methods: The study design was a retrospective and prospective analysis of 185 medical records of patients hospitalized in infectious diseases hospitals in Moscow from May to August 2021. Inclusion criteria were patients with and without NAFLD, aged over 18, hospitalized with COVID-19. Exclusion criteria were age under 18 years, alcoholic and viral liver damage. Processing of statistical data was carried out using the SPSS program and Excel application.
Results and discussion: In our study, the group of hospitalized patients with COVID-19 infection and NAFLD were older, their average age was 52.0 (42; 64.0). The dynamics of laboratory parameters of alanine aminotransferase (ALT), aspartate aminotransferase (AST), CRP, glutamylaminotransferase (GGTP) in patients of both groups showed statistically significant differences on days 1, 7 and 21 of hospitalization. In the group of patients with NAFLD, a statistically significant increase in the indicators of cytolysis and inflammation syndrome was observed, and their relationship proportionally correlated with the need for mechanical ventilation.
Conclusion: Cytolytic syndrome in patients with NAFLD hospitalized with COVID-19 infection is a predictor of severe course, longer hospitalization and the need for emergency medical interventions and additional costs.
Saule A. Alieva1,2, https://orcid.org/0000-0001-5098-9206
Igor G. Nikitin1, https://orcid.org/0000-0003-1699-0881
Irina V. Vasilyeva1, https://orcid.org/0000-0001-6986-901X
Evgeny I. Dedov1, https://orcid.org/0000-0002-9118-3708
Olga A. Ettinger1, https://orcid.org/0000-0002-1237-3731
Ulzhan S. Jamedinova2, https://orcid.org/0000-0003-1671-289X
Assel Zh. Baibussinova2, http://orcid.org/0000-0003-3447-6245
Assem D. Galymova2, https://orcid.org/0000-0001-9570-0971
1 Department of Hospital Therapy No. 2 named after. acad. G.I. Storozhakova, Faculty of Medicine, Federal State Autonomous Educational Institution of Higher Education “Russian National Research Medical University named after. N.I. Pirogov”, Ministry of Health of Russia, Moscow, Russian Federation;
2 NCJSC “Semey Medical University”, Semey, Republic of Kazakhstan.
1. Adolph T.E., Grander C., Grabherr F., Tilg H. Adipokines and Non-Alcoholic Fatty Liver Disease: Multiple Interactions. Int J Mol Sci. 2017 Jul 29;18(8):1649. doi: 10.3390/ijms18081649. PMID: 28758929; PMCID: PMC5578039
2. Bessone F., Razori M.V., Roma M.G. Molecular pathways of nonalcoholic fatty liver disease development and progression. Cell Mol Life Sci. 2019 Jan;76(1):99-128. doi: 10.1007/s00018-018-2947-0. Epub 2018 Oct 20. PMID: 30343320
3. Cai Q., Huang D., Yu H., Zhu Z., Xia Z., Su Y., Li Z., Zhou G., Gou J., Qu J., Sun Y. et al. COVID-19: Abnormal liver function tests. J Hepatol. 2020 Sep;73(3):566-574. doi: 10.1016/j.jhep.2020.04.006. Epub 2020 Apr 13. PMID: 32298767; PMCID: PMC7194951
4. Cai Q., Huang D., Ou P., Yu H., Zhu Zh., Xia Zh., Su Y., Ma Zh., Zhang Y., Li Zh., et al. COVID-19 in a designated infectious diseases hospital outside Hubei Province, China. Allergy, 2020;75(7):1742-1752. DOI:10.1111/all.14309
5. Chen H., Chen Q. COVID-19 Pandemic: Insights into Interactions between SARS-CoV-2 Infection and MAFLD. Int J Biol Sci. 2022 Jul 11;18(12):4756-4767. doi: 10.7150/ijbs.72461. PMID: 35874945; PMCID: PMC9305262.
6. Chen Z., Yu R., Xiong Y., Du F., Zhu S. A vicious circle between insulin resistance and inflammation in nonalcoholic fatty liver disease. Lipids Health Dis. 2017 Oct 16;16(1):203. doi: 10.1186/s12944-017-0572-9. Erratum in: Lipids Health Dis. 2018 Feb 23;17 (1):33. PMID: 29037210; PMCID: PMC5644081
7. COVID – 19 – infection: WHO Resources - https://www.who.int/ru/emergencies/diseases/novel-coronavirus-2019 (Accessed 12.01.2024)
8. Dietrich C.G., Geier A., Merle U. Non-alcoholic fatty liver disease and COVID-19: Harmless companions or disease intensifier? World J Gastroenterol. 2023 Jan 14;29(2):367-377. doi: 10.3748/wjg.v29.i2.367. PMID: 36687116; PMCID: PMC9846932.
9. Estes C., Razavi H., Loomba R., Younossi Z., Sanyal A.J. Modeling the epidemic of nonalcoholic fatty liver disease demonstrates an exponential increase in burden of disease. Hepatology. 2018 Jan;67(1):123-133. doi: 10.1002/hep.29466. Epub 2017 Dec 1. PMID: 28802062; PMCID: PMC5767767
10. Herta T., Berg T. COVID-19 and the liver - Lessons learned. Liver Int. 2021 Jun;41 Suppl 1(Suppl 1):1-8. doi: 10.1111/liv.14854. PMID: 34155789; PMCID: PMC8447354.
11. Huang Сh., Wang Y., Li X., Ren L., Zhao J., Hu Y., Zhang L., Fan G., Xu J., Gu X. et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet. 2020;395(10223):497 – 506. DOI:10.1016/s0140-6736(20).30183-5
12. Hughey C.C., Puchalska P., Crawford P.A. Integrating the contributions of mitochondrial oxidative metabolism to lipotoxicity and inflammation in NAFLD pathogenesis. Biochim Biophys Acta Mol Cell Biol Lipids. 2022 Nov;1867(11):159209. doi: 10.1016/j.bbalip.2022.159209. Epub 2022 Aug 4. PMID: 35934297
13. Ji D., Qin E., Xu J., Zhang D., Cheng G., Wang Y., Lau G. Non-alcoholic fatty liver diseases in patients with COVID-19: A retrospective study. J Hepatol. 2020 Aug;73(2):451-453. doi: 10.1016/j.jhep.2020.03.044. Epub 2020 Apr 8. PMID: 32278005; PMCID: PMC7141624.
14. Yoo H.W., Jin H.Y., Yon D.K., Effenberger M., Shin Y.H., Kim S.Y., Yang J.M., Kim M.S., Koyanagi A. et al. Non-alcoholic Fatty Liver Disease and COVID-19 Susceptibility and Outcomes: a Korean Nationwide Cohort. Journal of Korean Medical Science. 2021 Oct 25;36(41):e291. doi: 10.3346/jkms.2021.36.e291. PMID: 34697932; PMCID: PMC8546310.
15. Younossi Zobair M., Marchesini Giulio, Pinto-Cortez Helena, Petta Salvatore Epidemiology of Nonalcoholic Fatty Liver Disease and Nonalcoholic Steatohepatitis: Implications for Liver Transplantation. Transplantation 103(1):p 22-27, January 2019. | DOI: 10.1097/TP.0000000000002484
16. Younossi Z.M., Koenig A.B., Abdelatif D., Fazel Y., Henry L., Wymer M. Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology. 2016 Jul;64(1):73-84. doi: 10.1002/hep.28431. Epub 2016 Feb 22. PMID: 26707365
17. Ivashkin V.T., Drapkina O.M., I. V. Mayev et al. Prevalence of non-alcoholic fatty liver disease in patients of outpatient practice in the Russian Federation: results of the DIREG 2 study. Russian Journal of Gastroenterology, Hepatology, Coprology. 2015; 25(6):31–38 (in Russ.). 2015. С. 31-38
18. Li J., Tian A., Zhu H., Chen L., Wen J., Liu W., Chen P. Mendelian Randomization Analysis Reveals No Causal Relationship Between Nonalcoholic Fatty Liver Disease and Severe COVID-19. Clin Gastroenterol Hepatol. 2022 Jul;20(7):1553-1560.e78. doi: 10.1016/j.cgh.2022.01.045. Epub 2022 Feb 3. PMID: 35124268; PMCID: PMC8812093.
19. Medetalibeyoglu A., Catma Y., Senkal N., Ormeci A., Cavus B., Kose M., Bayramlar O..F, Yildiz G., Akyuz F., Kaymakoglu S., Tukek T. The effect of liver test abnormalities on the prognosis of COVID-19. Ann Hepatol. 2020 Nov-Dec;19(6):614-621. doi: 10.1016/j.aohep.2020.08.068. Epub 2020 Sep 10. PMID: 32920162; PMCID: PMC7481800
20. Mouries J., Brescia P., Silvestri A., Spadoni I., Sorribas M., Wiest R., Mileti E., Galbiati M., Invernizzi P., Adorini L. et al. Microbiota-driven gut vascular barrier disruption is a prerequisite for non-alcoholic steatohepatitis development. J Hepatol. 2019 Dec;71(6):1216-1228. doi: 10.1016/j.jhep.2019.08.005. Epub 2019 Aug 13. PMID: 31419514; PMCID: PMC6880766
21. Singh A., Hussain S., Antony B. Non-alcoholic fatty liver disease and clinical outcomes in patients with COVID-19: A comprehensive systematic review and meta-analysis. Diabetes Metab Syndr. 2021 May-Jun;15(3):813-822. doi: 10.1016/j.dsx.2021.03.019. Epub 2021 Mar 31. PMID: 33862417; PMCID: PMC8011308
22. Wang D. et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China // JAMA. 2020. Vol. 323, № 11. P. 1061–1069
23. Wang H., Mehal W., Nagy L.E., Rotman Y. Immunological mechanisms and therapeutic targets of fatty liver diseases. Cell Mol Immunol. 2021 Jan;18(1):73-91. doi: 10.1038/s41423-020-00579-3. Epub 2020 Dec 2. PMID: 33268887; PMCID: PMC7852578.
24. Xu Z., Shi L., Wang Y., Zhang J., Huang L., Zhang C., Liu S., Zhao P., Liu H., Zhu L. et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med. 2020 Apr;8(4):420-422. doi: 10.1016/S2213-2600(20)30076-X. Epub 2020 Feb 18. Erratum in: Lancet Respir Med. 2020 Feb 25;: PMID: 32085846; PMCID: PMC7164771
25. Zhang J.J., Cao Y.Y., Tan G., Dong X., Wang B.C., Lin J., Yan Y.Q., Liu G.H., Akdis M., Akdis C.A., Gao Y.D. Clinical, radiological, and laboratory characteristics and risk factors for severity and mortality of 289 hospitalized COVID-19 patients. Allergy. 2021 Feb;76(2):533-550. doi: 10.1111/all.14496. Epub 2020 Aug 24. PMID: 32662525; PMCID: PMC7404752
26. Zou X., Chen K., Zou J., Han P., Hao J., Han Z. Single-cell RNA-seq data analysis on the receptor ACE2 expression reveals the potential risk of different human organs vulnerable to 2019-nCoV infection. Front Med. 2020 Apr;14(2):185-192. doi: 10.1007/s11684-020-0754-0. Epub 2020 Mar 12. PMID: 32170560; PMCID: PMC7088738.
27. Zykina E.Y., Simonova Zh.G. Peculiarities of liver enzymes and clinical status of patients with new coronoviral infection (COVID-19) against background of excess body weight and obesity. Experimental and Clinical Gastroenterology. 2021;7(191): 6-11 (In Russ.)]. DOI:10.31146/1682-8658-ecg-191-7-6-11]
Количество просмотров: 5252
Категория статей:
Оригинальные исследования
Библиографическая ссылка
Alieva S.A., Nikitin I.G., Vasilyeva I.V., Dedov E.I., Ettinger O.A., Jamedinova U.S., Baibussinova A.Zh., Galymova A.D., Clinical and laboratory predictors of the severity of COVID-19 infection in patients with non-alcoholic fatty liver disease // Nauka i Zdravookhranenie [Science & Healthcare]. 2024, Vol.26. (2), pp. 104-112. doi 10.34689/SH.2024.26.2.014Похожие публикации:
TRENDS IN MORBIDITY AND MORTALITY FROM CHRONIC HEART FAILURE IN ALMATY
СТРУКТУРНО-ФУНКЦИОНАЛЬНЫЕ ИЗМЕНЕНИЯ МИОКАРДА ПОСЛЕ АОРТОКОРОНАРНОГО ШУНТИРОВАНИЯ У ПАЦИЕНТОВ С ИЗБЫТОЧНОЙ МАССОЙ ТЕЛА НА РАЗНЫХ ЭТАПАХ РЕАБИЛИТАЦИИ
МЕДИКО – СОЦИАЛЬНЫЕ, ПСИХОЛОГИЧЕСКИЕ АСПЕКТЫ КАЧЕСТВА ЖИЗНИ БОЛЬНЫХ С ОСТРЫМ ПАНКРЕАТИТОМ
A COMPARATIVE ANALYSIS OF 24-HOUR DIETARY RECALLS AND FOOD FREQUENCY QUESTIONNAIRES ADMINISTERED SIMULTANEOUSLY IN THE KAZAKHSTANI POPULATION
ANALYSIS OF PATIENT SATISFACTION WITH THE QUALITY OF ORGANIZATION OF TREATMENT IN FOREIGN CLINICS