COVID-19 mortality associated with inflammatory response in NAFLD patients

New research from Imperial looks at how underlying non-alcoholic fatty liver disease (NAFLD) impacts patient’s with COVID-19.

The study found that people with NAFLD tended to be younger than those with no NAFLD, and that NAFLD patients with a raised level of a blood marker of inflammation (called ferritin) were more likely to die from COVID-19. 

However, no evidence was found that either having NAFLD in of itself or the severity of NAFLD (i.e. degree of liver scarring) if it was present, influenced the likelihood of death from COVID-19.

A number of studies have looked at the impact that underlying medical conditions have on patients with COVID-19. These have shown that metabolic disorders, such as diabetes, obesity, or hypertension, may lead to patients developing the disease more severely than those without. However, what has been less well-understood, until now, is whether the presence of an underlying liver disease impacts upon a patient’s outcome from the infection.

One such liver disease of particular interest is non-alcoholic fatty liver disease, a common form of liver disease that affects approximately 25% of the entire population, and which is often found in association with other metabolic conditions such as diabetes or obesity. 

This research, led by researchers in the Department of Metabolism, Digestion and Reproduction, was performed through the analysis of medical admissions to Imperial College Healthcare NHS Trust during the peak of the COVID-19 pandemic.

Discussing the study’s findings, Dr Pinelopi Manousou, Consultant Hepatologist and Honorary Senior Lecturer, said: “COVID-19 infection has been – and unfortunately remains – a real risk for patients with metabolic conditions such as NAFLD. NAFLD is now the most common form of liver disease worldwide, and our specialist clinic at Imperial looks after approximately 600 patients with this condition. As such, it is important that we are learning the whole time everything we can to offer the best care to our NAFLD patients, and to minimise the burden of COVID-19 infection upon them.”

The results of the study are important for clinical practice, as it may influence decision making amongst doctors and nurses about best clinical care and treatment options for people with NAFLD who develop COVID-19. 

'In-hospital mortality is associated with inflammatory response in NAFLD patients admitted for COVID-19' by Roberta Forlano, Benjamin H. Mullish et al. is published in PLoS ONE. DOI: 10.1371/journal.pone.0240400