Independent Predictors of Mortality Among Patients With NAFLD Hospitalized With COVID‐19 Infection
The impact of the coronavirus disease 2019 (COVID‐19) pandemic among patients with chronic liver disease is unknown. Given the high prevalence of nonalcoholic fatty liver disease (NAFLD), we determined the predictors of mortality and hospital resource use among patients with NAFLD admitted with COVI...
| Main Authors: | , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Health/LWW
2022-11-01
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| Series: | Hepatology Communications |
| Online Access: | https://doi.org/10.1002/hep4.1802 |
| _version_ | 1797706052042489856 |
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| author | Zobair M. Younossi Maria Stepanova Brian Lam Rebecca Cable Sean Felix Thomas Jeffers Elena Younossi Huong Pham Manirath Srishord Patrick Austin Michael Estep Kathy Terra Carey Escheik Leyla deAvila Pegah Golabi Andrej Kolacevski Andrei Racila Linda Henry Lynn Gerber |
| author_facet | Zobair M. Younossi Maria Stepanova Brian Lam Rebecca Cable Sean Felix Thomas Jeffers Elena Younossi Huong Pham Manirath Srishord Patrick Austin Michael Estep Kathy Terra Carey Escheik Leyla deAvila Pegah Golabi Andrej Kolacevski Andrei Racila Linda Henry Lynn Gerber |
| author_sort | Zobair M. Younossi |
| collection | DOAJ |
| description | The impact of the coronavirus disease 2019 (COVID‐19) pandemic among patients with chronic liver disease is unknown. Given the high prevalence of nonalcoholic fatty liver disease (NAFLD), we determined the predictors of mortality and hospital resource use among patients with NAFLD admitted with COVID‐19 by using electronic medical records data for adult patients with COVID‐19 hospitalized in a multihospital health system who were discharged between March and December 2020. NAFLD was diagnosed by imaging or liver biopsy without other liver diseases. Charlson’s comorbidity index (CCI) and Elixhauser comorbidity index (ECI) scores were calculated. In the study sample, among the 4,835 patients hospitalized for COVID‐19, 553 had NAFLD (age: 55 ± 16 years, 51% male, 17% White, 11% Black, 58% Hispanic, 8% Asian, 5% from congregated living, 58% obese, 15% morbid obesity [body mass index ≥ 40], 51% type 2 diabetes, 63% hypertension, mean [SD] baseline CCI of 3.9 [3.2], and baseline ECI of 13.4 [11.3]). On admission, patients with NAFLD had more respiratory symptoms, higher body temperature and heart rate, higher alanine aminotransferase and aspartate aminotransferase than non‐NAFLD controls (n = 2,736; P < 0.05). Of the patients with NAFLD infected with COVID‐19, 3.9% experienced acute liver injury. The NAFLD group had significantly longer length of stay, intensive care unit use, and mechanical ventilation, with a crude inpatient mortality rate of 11%. In multivariate analysis, independent predictors of inpatient mortality among patients with NAFLD infected with COVID‐19 were older age, morbid obesity, ECI score ≥ 11, higher Fibrosis‐4 Index (FIB‐4) score, and oxygen saturation <90% (all P < 0.05), but not sex, race/ethnicity, or any individual comorbidity (all P > 0.05). Conclusion: Patients with NAFLD infected with COVID‐19 tend to be sicker on admission and require more hospital resource use. Independent predictors of mortality included higher FIB‐4 and multimorbidity scores, morbid obesity, older age, and hypoxemia on admission. |
| first_indexed | 2024-03-12T05:46:29Z |
| format | Article |
| id | doaj.art-6dc06c8e1ef64e35b359559ab68fca45 |
| institution | Directory Open Access Journal |
| issn | 2471-254X |
| language | English |
| last_indexed | 2024-03-12T05:46:29Z |
| publishDate | 2022-11-01 |
| publisher | Wolters Kluwer Health/LWW |
| record_format | Article |
| series | Hepatology Communications |
| spelling | doaj.art-6dc06c8e1ef64e35b359559ab68fca452023-09-03T05:36:19ZengWolters Kluwer Health/LWWHepatology Communications2471-254X2022-11-016113062307210.1002/hep4.1802Independent Predictors of Mortality Among Patients With NAFLD Hospitalized With COVID‐19 InfectionZobair M. Younossi0Maria Stepanova1Brian Lam2Rebecca Cable3Sean Felix4Thomas Jeffers5Elena Younossi6Huong Pham7Manirath Srishord8Patrick Austin9Michael Estep10Kathy Terra11Carey Escheik12Leyla deAvila13Pegah Golabi14Andrej Kolacevski15Andrei Racila16Linda Henry17Lynn Gerber18Inova Medicine Inova Health System Falls Church VA USAInova Medicine Inova Health System Falls Church VA USAInova Medicine Inova Health System Falls Church VA USAInova Medicine Inova Health System Falls Church VA USAInova Medicine Inova Health System Falls Church VA USAInova Medicine Inova Health System Falls Church VA USAInova Medicine Inova Health System Falls Church VA USAInova Medicine Inova Health System Falls Church VA USAInova Medicine Inova Health System Falls Church VA USAInova Medicine Inova Health System Falls Church VA USAInova Medicine Inova Health System Falls Church VA USAInova Medicine Inova Health System Falls Church VA USAInova Medicine Inova Health System Falls Church VA USAInova Medicine Inova Health System Falls Church VA USAInova Medicine Inova Health System Falls Church VA USAInova Medicine Inova Health System Falls Church VA USAInova Medicine Inova Health System Falls Church VA USAInova Medicine Inova Health System Falls Church VA USAInova Medicine Inova Health System Falls Church VA USAThe impact of the coronavirus disease 2019 (COVID‐19) pandemic among patients with chronic liver disease is unknown. Given the high prevalence of nonalcoholic fatty liver disease (NAFLD), we determined the predictors of mortality and hospital resource use among patients with NAFLD admitted with COVID‐19 by using electronic medical records data for adult patients with COVID‐19 hospitalized in a multihospital health system who were discharged between March and December 2020. NAFLD was diagnosed by imaging or liver biopsy without other liver diseases. Charlson’s comorbidity index (CCI) and Elixhauser comorbidity index (ECI) scores were calculated. In the study sample, among the 4,835 patients hospitalized for COVID‐19, 553 had NAFLD (age: 55 ± 16 years, 51% male, 17% White, 11% Black, 58% Hispanic, 8% Asian, 5% from congregated living, 58% obese, 15% morbid obesity [body mass index ≥ 40], 51% type 2 diabetes, 63% hypertension, mean [SD] baseline CCI of 3.9 [3.2], and baseline ECI of 13.4 [11.3]). On admission, patients with NAFLD had more respiratory symptoms, higher body temperature and heart rate, higher alanine aminotransferase and aspartate aminotransferase than non‐NAFLD controls (n = 2,736; P < 0.05). Of the patients with NAFLD infected with COVID‐19, 3.9% experienced acute liver injury. The NAFLD group had significantly longer length of stay, intensive care unit use, and mechanical ventilation, with a crude inpatient mortality rate of 11%. In multivariate analysis, independent predictors of inpatient mortality among patients with NAFLD infected with COVID‐19 were older age, morbid obesity, ECI score ≥ 11, higher Fibrosis‐4 Index (FIB‐4) score, and oxygen saturation <90% (all P < 0.05), but not sex, race/ethnicity, or any individual comorbidity (all P > 0.05). Conclusion: Patients with NAFLD infected with COVID‐19 tend to be sicker on admission and require more hospital resource use. Independent predictors of mortality included higher FIB‐4 and multimorbidity scores, morbid obesity, older age, and hypoxemia on admission.https://doi.org/10.1002/hep4.1802 |
| spellingShingle | Zobair M. Younossi Maria Stepanova Brian Lam Rebecca Cable Sean Felix Thomas Jeffers Elena Younossi Huong Pham Manirath Srishord Patrick Austin Michael Estep Kathy Terra Carey Escheik Leyla deAvila Pegah Golabi Andrej Kolacevski Andrei Racila Linda Henry Lynn Gerber Independent Predictors of Mortality Among Patients With NAFLD Hospitalized With COVID‐19 Infection Hepatology Communications |
| title | Independent Predictors of Mortality Among Patients With NAFLD Hospitalized With COVID‐19 Infection |
| title_full | Independent Predictors of Mortality Among Patients With NAFLD Hospitalized With COVID‐19 Infection |
| title_fullStr | Independent Predictors of Mortality Among Patients With NAFLD Hospitalized With COVID‐19 Infection |
| title_full_unstemmed | Independent Predictors of Mortality Among Patients With NAFLD Hospitalized With COVID‐19 Infection |
| title_short | Independent Predictors of Mortality Among Patients With NAFLD Hospitalized With COVID‐19 Infection |
| title_sort | independent predictors of mortality among patients with nafld hospitalized with covid 19 infection |
| url | https://doi.org/10.1002/hep4.1802 |
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