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Letter to the Editor: Obesity as a risk factor for greater severity of COVID-19 in patients with metabolic associated fatty liver disease
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“Of note, aging, obesity and inflammation-related diseases such as diabetes and cardiovascular diseases have been shown to be risk factors for the severity of COVID-19 (293, 371–373).”
From IL-6 in inflammation, autoimmunity and cancer (2021) · cites this paper as [371]
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Citations
Cites
Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China
Huang, C., Wang, Y., Li, X., Ren, L., Zhao, J., Hu, Y., Zhang, L., Fan, G., Xu, J., Gu, X., et al. (2020) · The Lancet · doi:10.1016/s0140-6736(20)30183-5 · Cited by 48,884 · cited 1×
“Systemic inflammatory response syndrome, a common complication in severe COVID-19 [12], is promoted by the activation of CD14+ and”
Clinical characteristics of coronavirus disease 2019 in China
Guan, W.-J., Ni, Z.-Y., Hu, Y., Liang, W.-H., Ou, C.-Q., He, J.-X., Liu, L., Shan, H., Lei, C.-L., Hui, D. S. C., et al. (2020) · New England Journal of Medicine · doi:10.1056/nejmoa2002032 · Cited by 30,246 · cited 1×
“Preliminary data suggests that obesity may aggravate the severity of respiratory diseases and of COVID-19 [2].”
Self-citationAlberti, K. G. M. M., Zimmet, P., & Shaw, J. (2006) · Diabetic Medicine · doi:10.1111/j.1464-5491.2006.01858.x · Cited by 6,597 · cited 1×
“hypertension and dyslipidemia were diagnosed based on established criteria.[10] All patients denied a history of chronic obstructive or restrictive pulmonary disease.”
BackgroundEslam, M., Newsome, P. N., Sarin, S. K., Anstee, Q. M., Targher, G., Romero-Gomez, M., Zelber-Sagi, S., Wai-Sun Wong, V., Dufour, J.-F., Schattenberg, J. M., et al. (2020) · Journal of Hepatology · doi:10.1016/j.jhep.2020.03.039 · Cited by 4,472 · cited 2×
“[2] Patients with metabolic associated fatty liver disease (MAFLD),[3] formerly known as non-alcoholic fatty liver disease, are often obese and have additional metabolic risk factors which may translate to a greater risk from respiratory diseases.”
BackgroundMethodSelf-citationvan der Poorten, D., Milner, K., Hui, J. M., Hodge, A. D., Trenell, M. I., Kench, J. G., London, R. M., Peduto, T., Chisholm, D. J., & George, J. (2008) · Hepatology · doi:10.1002/hep.22350 · Cited by 611 · cited 2×
“[13] In MAFLD patients, particularly those with obesity, increased inflammatory activity in the liver and visceral fat is independently correlated with increased levels of IL-6,[14] which might have an additive/synergistic role in promoting greater severity of COVID-19.”
BackgroundSelf-citationCOVID-19 and Liver Dysfunction: Current Insights and Emergent Therapeutic Strategies
Feng, G., Zheng, K. I., Yan, Q., Rios, R. S., Targher, G., Byrne, C. D., Poucke, S. V., Liu, W., & Zheng, M. (2020) · Journal of Clinical and Translational Hepatology · doi:10.14218/jcth.2020.00018 · Cited by 422 · cited 1×
“This suggests IL-6 is a key proinflammatory factor that triggers the inflammatory “storm” in patients.[13] In MAFLD patients, particularly those with obesity, increased inflammatory activity in the liver and visceral fat is independently correlated with increased levels of IL-6,[14] which might have an additive/synerg…”
BackgroundSelf-citationObesity Is a Risk Factor for Greater COVID-19 Severity
Gao, F., Zheng, K. I., Wang, X.-B., Sun, Q.-F., Pan, K.-H., Wang, T.-Y., Chen, Y.-P., Targher, G., Byrne, C., George, J., et al. (2020) · Diabetes Care · doi:10.2337/dc20-0682 · Cited by 376 · cited 1×
“for severe COVID-19 with a dose-effect relationship between increasing BMI and the proportion of patients with severe illness.[11] In the current analysis, the risk of severe illness in MAFLD patients with co-existing obesity was more than 6-fold greater after adjustment for confounders.”
BackgroundSelf-citationLean NAFLD: A Distinct Entity Shaped by Differential Metabolic Adaptation
Chen, F., Esmaili, S., Rogers, G. B., Bugianesi, E., Petta, S., Marchesini, G., Bayoumi, A., Metwally, M., Azardaryany, M. K., Coulter, S., et al. (2019) · Hepatology · doi:10.1002/hep.30908 · Cited by 338
Self-citationNseir, W., Mograbi, J., Amara, A., Abu-Elheja, O., & Mahamid, M. (2018) · QJM : monthly journal of the Association of Physicians · doi:10.1093/qjmed/hcy227 · Cited by 47 · cited 1×
“[4] [5] [6] [7] It is currently not known whether MALFD patients are also more likely to have greater COVID-19 severity of illness.”
Nonalcoholic fatty liver disease is associated with decreased lung function
Lee, C.-H., Choi, S.-H., Chung, G., Park, B., & Kwak, M.-S. (2018) · Liver international (Print) · doi:10.1111/liv.13860 · Cited by 36 · cited 1×
“[4] [5] [6] [7] It is currently not known whether MALFD patients are also more likely to have greater COVID-19 severity of illness.”
Cited by
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Items 301–320 of 320
Wicaksana, A. L., Hertanti, N. S., Pramono, R., & Hsu, Y.-Y. (2021) · Open Access Macedonian Journal of Medical Sciences · doi:10.3889/oamjms.2021.6585
Studi Literatur Digitalisasi Model 5A untuk Pengendalian Obesitas Saat Pandemi COVID-19
Pramesuari, F. D., Wibowo, D. A., Lie, E. C., & Christanti, J. (2021) · Praxis Jurnal Sains Teknologi Masyarakat dan Jejaring · doi:10.24167/praxis.v4i1.3382 · Cited by 2
Effect of obesity on immune response against covid-19
Ali, R. J., Haji, H. O., Zaki, S., aziz, Z. Y., Anwar, R., fars, H. S., salh, S. F., & Aziz, M. (2021) · Mosul Journal of Nursing · doi:10.33899/mjn.2021.169026
Relationship of SARS-CoV-2 and chronic diseases of nutritional origin
Bajaña, J. P., Carguacundo, E. R., Tumbaco, M. J. V., Silva-Ochoa, D., Grumo, D. D., Dorado-Sánchez, L., Orellana-Manzano, S., Manzano, P., & Orellana-Manzano, A. (2021) · Bionatura · doi:10.21931/rb/2021.06.03.34
Correlation Between COVID-19 Severity, Body Mass Index and Radiological Hepatic Morphology
Qandeel, H., Tayyem, R. M., Fataftah, J., Qasem, M., Sami, R., Ashour, H., Hasanat, S., Tayyem, R., & Alqassieh, R. (2021) · International Journal of Morphology · doi:10.4067/s0717-95022021000401096
Gastrointestinal manifestations of coronavirus disease 2019
Joshi, T., Ahmed, A., & Cholankeril, G. T. (2021) · Current Opinion in Infectious Diseases · doi:10.1097/qco.0000000000000760 · Cited by 3
Balfanz, P., Marx, N., & Müller-Wieland, D. (2021) · Adipositas - Ursachen Folgeerkrankungen Therapie · doi:10.1055/a-1296-0834
“In diesem Zusammenhang ist die Beobachtung interessant, dass eine ektope Fettanreicherung in der Leber, als metabolisch assoziierte Steatosis hepatis („Metabolic associated fatty liver disease“, MAFLD), das Risiko für schwere COVID-19Verläufe um das 6-Fache erhöht [6, 19].”
BackgroundIs High Body Mass Index a Risk Factor for COVID-19?
Kürklü, N. S., Keski̇n, A., & Türker, M. (2021) · Bezmialem Science · doi:10.14235/bas.galenos.2020.4859
“These studies found that increasing body mass index and obesity cause an increase in the severity of COVID-19 disease, the need for intensive care treatment, and mechanical ventilation (10,14).”
BackgroundOussou, Y., Nadhil, Z., & Cherti, M. (2021) · International Journal of Advanced Research · doi:10.21474/ijar01/12282
“AIS can settle within a median of 10 days after the onset of the first symptoms of COVID 19 [11,14], as it can initiate the clinical symptomatology before the onset of respiratory signs in rare cases, such as our patient .”
BackgroundPoinas, A., Boutoille, D., Vrignaud, F., Nguyen, J., Bonnet, F., Rat, C., Garcia, G., Dompmartin, A., Leccia, M., Piroth, L., et al. (2020) · doi:10.21203/rs.3.rs-29729/v2
Obesidade e COVID-19: Uma revisão integrativa
Serejo, A. H. H., dos Santos, J., de Melo, M. F., & Dutra, L. M. A. (2020) · Revista Científica Multidisciplinar Núcleo do Conhecimento · doi:10.32749/nucleodoconhecimento.com.br/saude/obesidade-e-covid-19
Brahmania, M., Congly, S., Jayakumar, S., Coffin, C., Burak, K., & Feld, J. (2020) · Canadian Liver Journal · doi:10.3138/canlivj-2020-0013
Qandeel, H., Tayyem, R. M., Fataftah, J., Qasem, M., Sami, R., Ashour, H., Hasanat, S., Tayyem, R., & Alqassieh, R. (2020) · doi:10.21203/rs.3.rs-77057/v1
Obesity and Metabolic Associated Fatty Liver Disease (MAFLD) as Risk Factors for COVID-19 Severity
Shiha, G. E.-S., Shiha, G. E.-S., & Soliman, R. (2020) · Journal of Diabetes Metabolism and its Complications · doi:10.31487/j.jdmc.2020.02.01
Theise, N., Arment, A., Chakravarty, D., Gregg, J. M. H., Jacobson, I., Jung, K.-H., Nair, S., Tewari, A., Thurston, A., Drie, J. V., et al. (2020) · bioRxiv · doi:10.1101/2020.07.12.199505
“cortisol had already been signaled by clinical aspects of patient populations at particular risk for SARS-CoV-2 infection and severe COVID-19 disease; individuals with advancing age (26), obesity and metabolic syndrome (27), and cardiovascular disease (28) also have strong associations for hypercortisolemia (29).”
BackgroundInteractions of SARS-CoV-2 infection with chronic obesity inflammation: a complex network phenomenonPreprint
Fávero, G. M., Mascarenhas, L. P. G., Furmann, M., Berton, J., & Miranda, P. J. (2020) · bioRxiv · doi:10.1101/2020.06.12.148577
“Thus, obesity is one of the main risk factors for coronavirus complications [17], due to the association established between obesity, chronic inflammation, and respiratory infection.”
BackgroundDevelopment of a risk prediction model for severe patients with COVID-19Preprint
Du, P., Shen, S., Ma, R., Zhang, Q., Zhao, H., Chen, M., Ni, M., Shen, Q., & Li, X. (2020) · doi:10.22541/au.159137421.16172030
“The above comorbidities have been reported in the literature as risk factors (Aghagoli et al., 2020; Cook, 2020; Jordan et al., 2020; Klonoff et al., 2020; Leung, 2020; Li et al., 2020; Li et al., 2020; Li et al., 2020; Liu et al., 2020; Liu et al., 2020; Long et al., 2020; Wei et al., 2020; Yang et al., 2020; Zhang e…”
InfluentialStudy the effect of the COVID-19 virus infection on liver function enzymes in Iraqi patients
Alhasnawi, E. A., Dewan, E. K., & Sahi, S. A. (2026) · Avicenna · doi:10.5339/avi.2026.15
The anthropometric indicators’ changes of patients after COVID-19
Saydalikhodjaeva, S., Boboyeva, Z., Akhmedova, D., & Azimova, S. (2023) · E3S Web of Conferences · doi:10.1051/e3sconf/202342005012
RetractedBoswell, K. (2021) · Critical Care of COVID-19 in the Emergency Department · doi:10.1007/978-3-030-85636-6_12
Metadata
- Authors
- Zheng, K. I., Gao, F., Wang, X.-B., Sun, Q.-F., Pan, K.-H., Wang, T.-Y., Ma, H.-L., Chen, Y.-P., Liu, W.-Y., George, J., & Zheng, M.-H.
- Affiliations
- First Affiliated Hospital of Wenzhou Medical University (CN)
- The University of Sydney (AU)
- Wenzhou Medical University (CN)
- Corresponding author
- George, Jacob
- Zheng, Ming-Hua
- Venue
- Metabolism
- Publisher
- Elsevier BV
- Published
- 2020-07
- Volume
- 108
- Pages
- 154244
- ISSN
- 0026-0495 (ISSN-L)
- PMC
- PMC7166301
- OpenAlex
- W3016610783
- Cited by
- 332
- References
- 14
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 10 · 2023: 28 · 2022: 44 · 2021: 101 · 2020: 140
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Metabolism (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- The Sydney eScholarship Repository (The University of Sydney) (submittedVersion)
- Funders
- National Natural Science Foundation of China (81500665)
- Topics
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Health Sciences › Medicine › Hepatology › Liver Disease Diagnosis and Treatment
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- obesity, COVID-19 severity, metabolic-associated fatty liver disease, non-alcoholic fatty liver disease, comorbidities, SARS-CoV-2, disease severity risk factors, metabolic risk factors, respiratory disease risk, hypoxia, innate immunity, lung function, SARS-CoV-2 viral load, SARS-CoV-2 variants
- MeSH terms
- Betacoronavirus, COVID-19, SARS-CoV-2, Adolescent, Adult, Aged, Female, Humans, Male, Middle Aged, Obesity, Pneumonia, Viral, Risk Factors, Coronavirus Infections, Young Adult, Pandemics, Non-alcoholic Fatty Liver Disease
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