Metabolic Dysfunction Associated with Fatty Liver Disease and COVID-19
Explore the association between Metabolic Dysfunction Associated Fatty Liver Disease (MAFLD) and COVID-19, including the risk of SARS-CoV-2 transmission, the role of ACE-2 receptors in liver health, potential therapeutic targets in MAFLD and liver fibrosis, as well as the impact of MAFLD on COVID-19 severity and prognosis. Understand the metabolic risk factors contributing to a severe course of COVID-19 and the implications of MAFLD on respiratory disease progression and liver biochemistry abnormalities.
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Presentation Transcript
LIVER CO-MORBIDITIES AND COVID-19 Metabolic Dysfunction Associated Fatty Liver Disease (MAFLD) and COVID- 19 Menso Westerouen van Meeteren and Joost PH Drenth Radboud UMC, Nijmegen, The Netherlands
Content MAFLD and risk of SARS-CoV-2 transmission MAFLD and COVID-19 prognosis.
Risk of acquiring SARS-CoV-2 infection Unknown if MAFLD increases risk of acquiring SARS-CoV-2 infection. ACE-2 receptor speculated as potential cause for increased transmission. ACE-II expression low in healthy liver Chronic liver injury increases ACE-2 expression in: Liver fibrosis mice models Human hepatitis C Cirrhosis explants (Paizis, Tikellis et al. 2005)
ACE-2 role in MAFLD Ang 1-7 activator reduces steatosis and inflammatory markers in mice ACE-2 activator decreases lipogenesis ACE-2 knock-out mice develop Insulin resistance Spontaneous liver fibrosis Feltenberger, Andrade et al. 2013 de Macedo, Guimarares et al. 2015) Osterreicher, Taura et al. 2009
RAS modulation in MAFLD & Liver injury RAS modulation potential therapeutic drug target in MAFLD and liver fibrosis (Ahmadian, Pennefather et al. 2016)
Metabolic risk factors & severe COVID-19 course Systematic review and meta-analysis, 20 articles (4062 COVID-19 patients) Diabetes, hypertension and CVD increased likelihood of severe disease (Xu, Mao et al. 2020)
MAFLD & COVID-19 severity Cohort study of 202 COVID-19 patients (MAFLD, n=76) Patients with MAFLD had: Higher risk of respiratory disease progression (44.7 vs. 6.6%) Higher likelihood of abnormal liver biochemistry (70% vs. 11.1%) (Xu, Mao et al. 2020)
MAFLD & COVID-19 severity Cohort study of N= 202 COVID-19 patients (MAFLD, n=76) Patients with MAFLD had: higher risk of respiratory disease progression (44.7 vs. 6.6%) higher likelihood of abnormal liver biochemistry (70% vs. 11.1%) (Xu, Mao et al. 2020)
Obesity in MAFLD patients & COVID-19 severity Chinese cohort study selected N=66 MAFLD patients Obesity (BMI > 25 kg/m2) (n=45) Increased the risk of severe COVID-19 Significant after adjustment for other risk factors (Zheng, Gao et al. 2020)
MAFLD and community acquired pneumonia (CAP) Nested case control study N=561 hospitalized CAP patients 30-day mortality from pneumonia: 17% in MAFLD patients 5.8% in non-MAFLD patients (Nseir, Mograbi et al. 2019)
Conclusions Unknown if MAFLD increases risk of SARS-CoV-2 transmission MAFLD and associated metabolic risk factors increase likelihood of severe course of COVID-19 disease.
