Non-Alcoholic Fatty Liver Disease (Nafld) Associates With Higher Risk Of Developing Symptomatic Covid19 Infection - Initial Uk Biobank Observations

Background: Severity of COVID-19 disease is associated with older age, male gender and pre-existing medical conditions A high proportion of infected patients develop liver injury, and reports indicate that patients with pre-existing fatty liver disease are at higher risk of experiencing severe COVID-19 Early data on COVID-19 testing from the large UK Biobank (UKB) study, allowed us to evaluate pre-existing liver disease as a risk factor for developing symptomatic COVID-19 Methods: Of 42,146 participants imaged to date in the UKB cohort, 397 had COVID-19 testing data available, with 97 positive and 300 negative results UK testing was initially restricted to those with symptoms in hospital therefore, a positive test is indicative of hospitalization with severe COVID-19 MRI derived biomarkers of liver fat (PDFF;%) and fibroinflammation (cT1;ms) were generated using LiverMultiScan® software Univariate and multivariate analysis were performed on liver biomarkers to determine if these variables increased risk of symptomatic COVID-19 and compared to previously described risk factors An additional multivariate model using a metabolic risk variable, composed by BMI and liver fat iterations, was also assessed Results: Univariate analysis showed previously known risk factors linked to COVID-19 positivity (BMI (p= 0 0006), being male (p=0 03), being of non-white ethnicity (p=0 0002) and having hypertension (p= 0 004)) increasing the odds of testing positive for COVID-19, surviving multivariate analysis Multivariate adding BMI with liver fat as an interaction term revealed a relationship between BMI and being hospitalized with severe positive COVID-19 (p= 0 0002) We also explored the \u0027hepaticmetabolic risk\u0027 by stratifying our participants based on obesity and liver fat status Results demonstrated that, in addition to previously known risk factors, having high liver fat (≥10%) + being obese (≥30kg/m2) was a significant predictor of testing positive (2 47[CI: 1 3-4 7]) Conclusion: This research provides further evidence on the link between NAFLD and the risk of hospitalization with severity of COVID-19 In obese participants, an increased risk of symptomatic disease was not observed in patients without concomitant fatty liver This highlights the value of identifying this high-risk subpopulation with non-invasive imaging to guide clinical and lifestyle interventions Figure 1: Representative LiverMultiScan® images from the UK-Biobank cohort, showing multivariate analysis of metabolic risk variable BMI \u003c30 Kg/m2) and \u003c10% liver fat was used as reference healthy population Odds ratio and confidence intervals of the associations between obesity and liver fat are presented Abbreviations: BMI, body mass index;OR, odds ratio;CI, confidence interval Significance is indicated by ∗p≤0 05 Reproduced by kind permission of UK Biobank© (Figure Presented)