Journal
FRONTIERS IN ENDOCRINOLOGY
Volume 12, Issue -, Pages -Publisher
FRONTIERS MEDIA SA
DOI: 10.3389/fendo.2021.604100
Keywords
COVID-19; SARS-CoV-2; MAFLD; cytokine; IL-6; NAFLD
Categories
Funding
- National Natural Science Foundation of China [82070588]
- Medical Health Science and Technology Project of Zhejiang Provincial Health Commission [2018ZD039]
- Ruian Science and Technology Bureau [2020023]
- High Level Creative Talents from Department of Public Health in Zhejiang Province
- Project of New Century 551 Talent Nurturing in Wenzhou
- University School of Medicine of Verona, Verona, Italy
- Southampton NIHR Biomedical Research Centre, UK [IS-BRC-20004]
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The study found that patients with MAFLD had higher serum IL-6 levels at admission, and these patients were at higher risk of developing severe COVID-19. Even after adjusting for age, sex, and metabolic comorbidities, increased serum IL-6 levels remained associated with a higher risk of severe COVID-19, especially among infected patients with MAFLD. The interaction effect between serum IL-6 levels and MAFLD for the risk of severe COVID-19 was significant.
Background and Aim: Circulating levels of interleukin (IL)-6, a well-known inflammatory cytokine, are often elevated in coronavirus disease-2019 (COVID-19). Elevated IL-6 levels are also observed in patients with metabolic dysfunction-associated fatty liver disease (MAFLD). Our study aimed to describe the association between circulating IL-6 levels and MAFLD at hospital admission with risk of severe COVID-19. Methods: A total of 167 patients with laboratory-confirmed COVID-19 from three Chinese hospitals were enrolled. Circulating levels of IL-2, IL-4, IL-6, IL-10, tumor necrosis factor (TNF)-alpha, and interferon (IFN)-gamma were measured at admission. All patients were screened for fatty liver by computed tomography. Forty-six patients were diagnosed as MAFLD. Results: Patients with MAFLD (n = 46) had higher serum IL-6 levels (median 7.1 [interquartile range, 4.3-20.0] vs. 4.8 [2.6-11.6] pg/mL, p = 0.030) compared to their counterparts without MAFLD (n = 121). After adjustment for age and sex, patients with MAFLD had a similar to 2.6-fold higher risk of having severe COVID-19 than those without MAFLD. After adjustment for age, sex and metabolic co-morbidities, increased serum IL-6 levels remained associated with higher risk of severe COVID-19, especially among infected patients with MAFLD (adjusted-odds ratio 1.14, 95% CI 1.05-1.23; p = 0.002). There was a significant interaction effect between serum IL-6 levels and MAFLD for risk of severe COVID-19 (p for interaction = 0.008). Conclusions: Patients with MAFLD and elevated serum IL-6 levels at admission are at higher risk for severe illness from COVID-19.
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