Metabolic associated fatty liver disease increases coronavirus disease 2019 disease severity in nondiabetic patients

Gao, Feng; Zheng, Kenneth I; Wang, Xiao‐Bo; Yan, Hua‐Dong; Sun, Qing‐Feng; Pan, Ke‐Hua; Wang, Ting‐Yao; Chen, Yong‐Ping; George, Jacob; Zheng, Ming‐Hua

BACKGROUND AND AIM: Coronavirus disease 2019 (COVID‐19) has attracted increasing worldwide attention. While diabetes is known to aggravate COVID‐19 severity, it is not known whether nondiabetic patients with metabolic dysfunction are also more prone to more severe disease. The association of metabolic associated fatty liver disease (MAFLD) with COVID‐19 severity in nondiabetic patients was investigated here. METHODS: The study cohort comprised 65 patients with (i.e. cases) and 65 patients without MAFLD (i.e. controls). Each case was randomly matched with one control by sex (1:1) and age (±5 years). The association between the presence of MAFLD (as exposure) and COVID‐19 severity (as the outcome) was assessed by binary logistic regression analysis. RESULTS: In nondiabetic patients with COVID‐19, the presence of MAFLD was associated with a four‐fold increased risk of severe COVID‐19; the risk increased with increasing numbers of metabolic risk factors. The association with COVID‐19 severity persisted after adjusting for age, sex, and coexisting morbid conditions. CONCLUSION: Health‐care professionals caring for nondiabetic patients with COVID‐19 should be cognizant of the increased likelihood of severe COVID‐19 in patients with MAFLD.