Background: The most common pre-existing liver disease, the metabolic dysfunction-associated fatty liver disease (MAFLD) formerly named as non-alcoholic fatty liver disease (NAFLD), may have a negative impact on the severity of COVID-19. This meta-analysis aimed to evaluate if MAFLD or NAFLD are associated with a more severe disease course of COVID-19. Methods: A systematic search was performed in five databases for studies comparing severity, the rate of intensive care unit (ICU) admission, and mortality of COVID-19 patients with and without MAFLD or NAFLD. In meta-analysis, pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Results: Altogether, we included nine studies in our quantitative and qualitative synthesis. MAFLD was associated with an increased risk of severe COVID-19 compared to the non-MAFLD group (28 vs. 13%, respectively; OR = 2.61, CI: 1.75–3.91). Similarly, in the NAFLD vs. non-NAFLD comparison, NAFLD proved to be a risk factor as well (36 vs. 12%, respectively; OR = 5.22, CI: 1.94–14.03). On the other hand, NAFLD was not associated with an increased risk of ICU admission (24 vs. 7%, respectively; OR = 2.29, CI: 0.79–6.63). We were unable to perform meta-analysis to investigate the association of MAFLD with the rate of ICU admission and with mortality. Conclusion: In conclusion, patients with MAFLD and NAFLD showed a more severe clinical picture in COVID-19. Our results support the importance of close monitoring of COVID-19 patients with MAFLD. Further research is needed to explore the cause of increased severity of COVID-19 in MAFLD.
【저자키워드】 COVID-19, SARS-CoV-2, pandemic, Prognosis, Non-alcoholic fatty liver disease, metabolic associated fatty liver disease, 【초록키워드】 Meta-analysis, Mortality, intensive care, severe COVID-19, severity, risk factor, database, ICU, clinical picture, severity of COVID-19, Research, Patient, ICU admission, Fatty liver, disease, Quantitative, Admission, association, Odds ratio, Liver disease, COVID-19 patient, NAFLD, Support, 95% confidence interval, increased risk, non-NAFLD, close monitoring, severe disease course, FIVE, evaluate, nine, was performed, calculated, CIs, 【제목키워드】 review, metabolic, Increased,