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COVID-19 Impact: Higher Risks of Severity Among Obese and Chronic Liver Disease Patients

The COVID-19 pandemic has emerged as a complicated and pernicious disease. Recently, the Centers for Disease Control and Prevention (CDC) warns that adults of any age with certain underlying medical conditions are at increased risk for severe illness from the virus that causes COVID-19—leading to hospitalization, admission to the ICU, intubation or death.

The CDC also warns that adults of any age with obesity are at increased risk of severe illness from the virus that causes COVID-19, while adults of any age with liver disease might be at an increased risk for severe illness from the virus that causes COVID-19.

Research conducted at Perspectum Ltd and Virginia Commonwealth University underscores the value of identifying patients with both obesity and high liver fat using noninvasive imaging to guide clinical and lifestyle interventions.


Studies Measure COVID-19 Severity Risks Due to Liver Disease

recent study shows that in people with more than 10% liver fat, obesity more than doubled the odds of having COVID-19 symptoms when testing positive for coronavirus infection and tripled the chances of hospital admission with severe COVID-19.

Other studies found that:

  • Chronic liver disease boosts the risk of COVID-19 6-fold, a rate similar to the COVID-19 risks associated with males, diabetes, hypertension and smoking
  • People admitted to the hospital with COVID-19 often have abnormal liver function
  • Abnormal liver function tests upon hospital admission with COVID-19 inflate chances of severe COVID-19 and death even in people without diagnosed chronic liver disease
  • Elevated levels of liver fat (>10%) are associated with a 2.3-fold increase in risk of severe disease and a 3.0-fold increase in risk of being hospitalized

In addition, it was found that in people with low liver fat, obesity alone does not raise the chances of being diagnosed with symptomatic COVID-19 or being admitted to the hospital with severe COVID-19. Obesity in addition to high liver fat, however, posed high clinical COVID-19 risks in this population.


Non-invasive Tools to Assess Liver Health May Inform Treatment Plans

FibroScan® is a pain-free, non-invasive examination of the liver. This 10-minute point-of-care procedure provides a quantitative assessment of liver stiffness and liver fat at the point of care to make the detection of liver disease and long-term care for individuals with non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) more effective. A recent publication identified VCTE™ as a useful tool in assessing onset and severity of acute liver injury in COVID-19 patients.  Increased liver stiffness at baseline was associated with a more severe and complicated course of disease.

During the COVID-19 pandemic and beyond, it will be critical for clinicians to help reverse the nation’s liver disease epidemic through early detection and monitoring of NAFLD/NASH and support lifestyle management programs.

While this unprecedented health care crisis has exacerbated a number of underlying and troublesome issues across the U.S. health care system, it has also highlighted opportunities for solving these problems, and supporting innovations that advance preventive care, address critical health care needs and improve outcomes for more Americans.

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