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©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
Impact of non-alcoholic fatty liver disease on coronavirus disease 2019: A systematic review
Abdul Moeed, Muhammad Omar Larik, Muhammad Ahmed Ali Fahim, Hafsah Alim Ur Rahman, Lubna Najmi, Mah I Kan Changez, Muhammad Moiz Javed, Md Al Hasibuzzaman
Abdul Moeed, Muhammad Ahmed Ali Fahim, Hafsah Alim Ur Rahman, Department of Internal Medicine, Dow University of Health Sciences, Karachi 74200, Sindh, Pakistan
Muhammad Omar Larik, Department of Internal Medicine, Dow International Medical College, Karachi 74200, Sindh, Pakistan
Lubna Najmi, Department of Internal Medicine, Ziauddin University, Karachi 75000, Sindh, Pakistan
Mah I Kan Changez, Department of Research, Yale University, New Haven 06520, CT, United States
Muhammad Moiz Javed, Department of Internal Medicine, King Edward Medical University, Lahore 54000, Punjab, Pakistan
Md Al Hasibuzzaman, Institute of Nutrition and Food Science, University of Dhaka, Dhaka 1000, Bangladesh
Md Al Hasibuzzaman, Department of Medicine, The Affiliated Hospital of Medical School of Ningbo University, Ningbo 315211, Zhejiang Province, China
Author contributions: Moeed A, Larik MO, Fahim MAA, and Rahman HAU participated in the conceptualization, data curation, investigation, methodology, project administration, resources, supervision, validation, visualization, and writing of the original draft; Najmi L, Changez MIK, and Javed MM were involved in project administration and writing of the original draft; Fahim MAA, Moeed A, and Hasibuzzaman MA were involved in the project administration, supervision, validation, visualization, writing, review, and editing; All authors have read and approved the final manuscript.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Md Al Hasibuzzaman, MBBS, Doctor, Researcher, Institute of Nutrition and Food Science, University of Dhaka, Suhrawardi Udyan Road, Dhaka 1000, Bangladesh.
al.hasibuzzaman.hasib@gmail.com
Received: June 19, 2024
Revised: July 17, 2024
Accepted: July 26, 2024
Published online: August 27, 2024
Processing time: 63 Days and 16.8 Hours
BACKGROUND
Many studies have revealed a link between non-alcoholic fatty liver disease (NAFLD) and coronavirus disease 2019 (COVID-19), making understanding the relationship between these two conditions an absolute requirement.
AIM
To provide a qualitative synthesis on the currently present data evaluating COVID-19 and NAFLD.
METHODS
This systematic review was conducted in accordance with the guidelines provided by preferred reporting items for systematic reviews and meta-analyses and the questionnaire utilized the population, intervention, comparison, and outcome framework. The search strategy was run on three separate databases, PubMed/MEDLINE, Scopus, and Cochrane Central, which were systematically searched from inception until March 2024 to select all relevant studies. In addition, ClinicalTrials.gov, Medrxiv.org, and Google Scholar were searched to identify grey literature.
RESULTS
After retrieval of 11 studies, a total of 39282 patients data were pooled. Mortality was found in 11.5% and 9.4% of people in NAFLD and non-NAFLD groups. In all, 23.2% of NAFLD patients and 22% of non-NAFLD admissions diagnosed with COVID-19 were admitted to the intensive care unit, with days of stay varying. Ventilatory support ranged from 5% to 40.5% in the NAFLD cohort and from 3.1% to 20% in the non-NAFLD cohort. The incidence of acute liver injury showed significance. Clinical improvement on days 7 and 14 between the two classifications was significant. Hospitalization stay ranged from 9.6 days to 18.8 days and 7.3 days to 16.4 days in the aforementioned cohorts respectively, with 73.3% and 76.3% of patients being discharged. Readmission rates varied.
CONCLUSION
Clinical outcomes except mortality consistently showed a worsening trend in patients with NAFLD and concomitant COVID-19. Further research in conducting prospective longitudinal studies is essential for a more powerful conclusion.
Core Tip: Non-alcoholic fatty liver disease (NAFLD) and coronavirus disease 2019 (COVID-19) have both shown increasing rates over the years, with the liver being the second most affected organ in COVID-19 after the lungs. Several studies have suggested that COVID-19 patients with concomitant NAFLD have a higher risk for severe disease. Therefore, this systematic review provides a comprehensive overview of improvements, complications, mortality, and intensive care unit- and hospital-related outcomes in COVID-19 patients with and without NAFLD.
