March 29, 2021
New research published this month in Frontiers in Medicine (Gastroenterology) reveals that individuals with both obesity and severe fatty liver are five times more likely to require hospitalization for the illness. The non-invasive liver imaging technology — Perspectum’s LiverMultiScan — was used to gather MRI scans for the study.
Obesity is often associated with fat accumulation in the liver, which can lead to liver disease, and emerging data suggest that patients with obesity are at an increased risk of becoming seriously ill with COVID-19. The World Obesity Federation summarizes recent reports suggesting in the US almost 50 percent of people hospitalized with COVID-19 were also affected by obesity. A new report from the CDC (Centers for Disease Control and Prevention, U.S.A.) indicates 78 percent of people who were hospitalized, placed on a ventilator, or died from COVID-19 were overweight or obese.
The results of the imaging study, which explored whether having excess liver fat could influence the severity of COVID-19 in obese individuals, showed that individuals with both obesity as well as fatty liver were five times more likely to require hospitalization for COVID-19. Notably, individuals with obesity and normal liver fat were not at increased risk of being hospitalized.
“Some individuals with obesity have a normal level of liver fat and some non-obese individuals have high levels of liver fat. It is pertinent to establish whether pre-existing liver disease increases the risk of severe COVID-19 and how this relates to obesity,” says Adriana Roca-Fernandez, first author and scientist at Perspectum, the company developing LiverMultiScan. “Measurement of liver fat and detection of liver disease can be achieved using non-invasive imaging methods such as Perspectum’s well-validated, magnetic resonance imaging (MRI) technology to help identify patients with COVID-19 who are at increased risk of severe disease.”
Understanding the contribution of liver fat to COVID-19 risk and outcomes is important for clinical understanding and management of COVID-19 and long COVID. The study, “Hepatic Steatosis Rather Than Underlying Obesity Increases Risk of Infection and Hospitalization for COVID-19,” Roca-Fernandez et al., 2021, also confirmed some previously reported risk factors for contracting COVID-19, such as being a male and having a lower socioeconomic status. In addition, this study showed that the participants who had tested positive for COVID-19 were more likely to have higher liver fat. The MRI data were acquired before the COVID-19 pandemic by the UK Biobank, one of the largest biomedical databases in the world, and included 4,458 people who had later been tested for COVID-19.
According to Dr. Arun Sanyal, Virginia Commonwealth University, one of the authors of the study, “The current study demonstrates pre-existing fatty liver disease is an independent risk factor for the development of severe disease in those with COVID-19. This raises important questions about the role of hepatic steatosis and related liver injury as a disease-modifying factor. These data highlight the public health relevance of NAFLD beyond cardiovascular, cancer and liver outcomes and provide a strong rationale for future studies to evaluate whether de-fatting the liver will reduce the likelihood of severe COVID-19 in affected individuals.”
“Determining all risk factors for increased severity of COVID-19 is crucial to help shape public policy measures to protect these high-risk individuals, such as social distancing, prioritization of people for vaccinations, and access to personalized medicine to guide clinical and lifestyle interventions,” adds Roca- Fernandez.