CLINICAL AND LABORATORY PREDICTORS OF THE SEVERITY OF COVID-19 INFECTION IN PATIENTS WITH NON-ALCOHOLIC FATTY LIVER DISEASE

Abstract

Background: The clinical course of COVID-19 infection varied from mild, sometimes asymptomatic manifestations to severe ones, requiring mandatory hospitalization and emergency care, up to the need for artificial pulmonary ventilation (ALV). Increased risk factors for adverse outcomes included older age and comorbid conditions, including non-alcoholic fatty liver disease (NAFLD). Many studies have focused on the severity of COVID-19 in patients with non-alcoholic fatty liver disease (NAFLD) during the pandemic, but few of them fully reflect the clinical features of COVID-19 infection in hospitalized patients with NAFLD. Aim: Evaluation of the relationship between laboratory parameters and the severity of COVID-19 infection in hospitalized patients with NAFLD. Materials and methods: The study design was a retrospective and prospective analysis of 185 medical records of patients hospitalized in infectious diseases hospitals in Moscow from May to August 2021. Inclusion criteria were patients with and without NAFLD, aged over 18, hospitalized with COVID-19. Exclusion criteria were age under 18 years, alcoholic and viral liver damage. Processing of statistical data was carried out using the SPSS program and Excel application. Results and discussion: In our study, the group of hospitalized patients with COVID-19 infection and NAFLD were older, their average age was 52.0 (42; 64.0). The dynamics of laboratory parameters of alanine aminotransferase (ALT), aspartate aminotransferase (AST), CRP, glutamylaminotransferase (GGTP) in patients of both groups showed statistically significant differences on days 1, 7 and 21 of hospitalization. In the group of patients with NAFLD, a statistically significant increase in the indicators of cytolysis and inflammation syndrome was observed, and their relationship proportionally correlated with the need for mechanical ventilation. Conclusion: Cytolytic syndrome in patients with NAFLD hospitalized with COVID-19 infection is a predictor of severe course, longer hospitalization and the need for emergency medical interventions and additional costs.