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Outcome of Patients with Metabolic-Associated Fatty Liver Disease Who Are Infected with SARS-CoV-2: A Meta-Analysis

ACTA MEDICA INDONESIANA · Vol. 57 No. 1 (2025)

ISSN
2338-2732, 0125-9326
Published
2025-04-15
Publisher
The Indonesian Society of Internal Medicine
Language
eng

Abstract

Background: Metabolic-associated fatty liver disease (MAFLD) is excess fat accumulation in the liver due to metabolic syndrome. Coronavirus disease 2019 (COVID-19) is an infection caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). SARS-CoV-2 not only attacks the respiratory system but also involves systemic and extra-pulmonary organ disorders, including liver disorders. This review evaluates the severity of COVID-19, mortality, and length of hospital stays of patients with MAFLD who were infected with SARS-CoV-2. Methods: Literature searches were conducted through various online databases. The risk of bias assessment was conducted by two researchers using the Newcastle Ottawa Scale tool for NRSI studies, and any discrepancies were resolved by another team member. The meta-analysis was performed using Revman 5.4.1 and results were presented in forest plot by calculating the pooled odds ratio or mean difference between the MAFLD and non-MAFLD groups from the evaluated studies with a 95% CI. Results: The results of the meta-analysis using a fixed-effect model from seven studies showed that COVID-19 patients with MAFLD were associated with a higher mortality compared to those without MAFLD (OR 1.41, 95% CI 1.19-1.69, p=0.01, I2 48). However, there were no differences in COVID-19 severity (OR 3.12, IK95% 0.89–11.03, p=0.08, I2 92) and length of hospital stay (MD 1.27, CI95% 0.03–2.52, p=0.04, I2 80) between the two groups. Conclusion: MAFLD patients infected with SARS-CoV-2 were associated with higher mortality than non-MAFLD patients, but they were not associated with greater severity of COVID-19 nor a longer duration of hospitalization.

Keywords

Collaboration network of the authors

40 authors · 299 co-authorship links · showing the 40 most connected

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  • University of Indonesia
  • Affiliation unknown
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Co-authorOrganisationJoint articles
Sukamto KoesnoeAffiliation unknown9
Anshari Saifuddin HasibuanAffiliation unknown8
Rudi PutrantoAffiliation unknown7
Suzy MariaAffiliation unknown6
Pringgodigdo NugrohoAffiliation unknown6
Juferdy KurniawanAffiliation unknown5
Evy YunihastutiAffiliation unknown5
Iris RengganisAffiliation unknown5
Siti SetiatiAffiliation unknown5
Teguh Harjono KarjadiAffiliation unknown5
Hamzah ShatriAffiliation unknown5
Ikhwan RinaldiAffiliation unknown5
Irsan HasanAffiliation unknown4
Imam SubektiAffiliation unknown4
Samsuridjal DjauziAffiliation unknown4
Pradana SoewondoAffiliation unknown3
Rino Alvani GaniAffiliation unknown3
Cosmas Rinaldi A LesmanaAffiliation unknown3
Kemal Fariz KalistaAffiliation unknown3
Murdani AbdullahAffiliation unknown3
Wismandari WisnuAffiliation unknown3
Sally Aman NasutionAffiliation unknown3
Robert SintoAffiliation unknown3
Cleopas Martin RumendeAffiliation unknown3
Tri Juli Edi TariganUniversity of Indonesia2
Suharko SoebardiAffiliation unknown2
Dante Saksono HarbuwonoAffiliation unknown2
Budiman DarmowidjojoAffiliation unknown2
Dicky Levenus TahaparyAffiliation unknown2
Farid KurniawanAffiliation unknown2
Indrati SuroyoAffiliation unknown2
Alvita Dewi SiswoyoAffiliation unknown2
Soehartati GondhowiardjoAffiliation unknown2
Arif MansjoerAffiliation unknown2
Andri SanityosoAffiliation unknown2
Marcellus SimadibrataAffiliation unknown2

Affiliations come from OpenAlex; journal OAI-PMH metadata carries none. Authors without an OpenAlex ID are matched by name, which can merge or split people.

Metadata source: OAI-PMH (metadata jurnal) http://www.actamedindones.org/index.php/ijim/oai, first harvested 8 Nov 2026, last seen 8 Nov 2026.
Original metadata (oai_dc) 
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	<dc:title xml:lang="en-US">Outcome of Patients with Metabolic-Associated Fatty Liver Disease Who Are Infected with SARS-CoV-2:  A Meta-Analysis</dc:title>
	<dc:creator>Jasirwan, Chyntia Olivia Maurine</dc:creator>
	<dc:creator>Purnamasari, Dyah</dc:creator>
	<dc:creator>Widhani, Alvina</dc:creator>
	<dc:creator>Kamila, Tasya</dc:creator>
	<dc:subject xml:lang="en-US">COVID-19</dc:subject>
	<dc:subject xml:lang="en-US">MAFLD</dc:subject>
	<dc:subject xml:lang="en-US">outcome</dc:subject>
	<dc:subject xml:lang="en-US">severity</dc:subject>
	<dc:subject xml:lang="en-US">mortality</dc:subject>
	<dc:subject xml:lang="en-US">length of hospital stays</dc:subject>
	<dc:description xml:lang="en-US">Background: Metabolic-associated fatty liver disease (MAFLD) is excess fat accumulation in the liver due to metabolic syndrome. Coronavirus disease 2019 (COVID-19) is an infection caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). SARS-CoV-2 not only attacks the respiratory system but also involves systemic and extra-pulmonary organ disorders, including liver disorders. This review evaluates the severity of COVID-19, mortality, and length of hospital stays of patients with MAFLD who were infected with SARS-CoV-2. Methods: Literature searches were conducted through various online databases. The risk of bias assessment was conducted by two researchers using the Newcastle Ottawa Scale tool for NRSI studies, and any discrepancies were resolved by another team member. The meta-analysis was performed using Revman 5.4.1 and results were presented in forest plot by calculating the pooled odds ratio or mean difference between the MAFLD and non-MAFLD groups from the evaluated studies with a 95% CI. Results: The results of the meta-analysis using a fixed-effect model from seven studies showed that COVID-19 patients with MAFLD were associated with a higher mortality compared to those without MAFLD (OR 1.41, 95% CI 1.19-1.69, p=0.01, I2 48). However, there were no differences in COVID-19 severity (OR 3.12, IK95% 0.89–11.03, p=0.08, I2 92) and length of hospital stay (MD 1.27, CI95% 0.03–2.52, p=0.04, I2 80) between the two groups. Conclusion: MAFLD patients infected with SARS-CoV-2 were associated with higher mortality than non-MAFLD patients, but they were not associated with greater severity of COVID-19 nor a longer duration of hospitalization.</dc:description>
	<dc:publisher xml:lang="en-US">The Indonesian Society of Internal Medicine</dc:publisher>
	<dc:date>2025-04-15</dc:date>
	<dc:type>info:eu-repo/semantics/article</dc:type>
	<dc:type>info:eu-repo/semantics/publishedVersion</dc:type>
	<dc:format>application/pdf</dc:format>
	<dc:identifier>http://www.actamedindones.org/index.php/ijim/article/view/2931</dc:identifier>
	<dc:source xml:lang="en-US">Acta Medica Indonesiana; Vol. 57 No. 1 (2025): Acta Medica Indonesiana; 61</dc:source>
	<dc:source>2338-2732</dc:source>
	<dc:source>0125-9326</dc:source>
	<dc:language>eng</dc:language>
	<dc:relation>http://www.actamedindones.org/index.php/ijim/article/view/2931/pdf</dc:relation>
	<dc:rights xml:lang="en-US">Copyright (c) 2025 Acta Medica Indonesiana</dc:rights>
</oai_dc:dc>