Table 2. Severity-dependent association between risk of the COVID-19-related outcomes and NAFLD by BARD scoring system in the Korean nationwide cohort (total n = 74,244).
| Event | Exposure | None | NAFLD without advanced fibrosisa | NAFLD with advanced fibrosisa | |
|---|---|---|---|---|---|
| COVID-19 | HSI-NAFLD | ||||
| Event number/total number (%) | 1,413/48,203 (2.9) | 582/18,512 (3.1) | 256/7,529 (3.4) | ||
| aORb (95% CI) | 1.0 (ref) | 1.05 (0.95–1.16) | 1.20 (1.06–1.34) | ||
| FLI-NAFLD | |||||
| Event number/total number (%) | 1,553/54,299 (2.9) | 570/16,515 (3.5) | 128/3,430 (3.4) | ||
| aORb (95% CI) | 1.0 (ref) | 1.23 (1.11–1.35) | 1.32 (1.11–1.59) | ||
| Claims-based NAFLD | |||||
| Event number/total number (%) | 1,925/65,317 (3.0) | 253/7,053 (3.6) | 73/1,874 (3.9) | ||
| aORb (95% CI) | 1.0 (ref) | 1.14 (1.01–1.34) | 1.26 (0.98–1.61) | ||
| Severe COVID-19c | HSI-NAFLD | ||||
| Event number/total number (%) | 259/48,203 (0.5) | 105/18,512 (0.6) | 74/7,529 (1.0) | ||
| aORb (95% CI) | 1.0 (ref) | 1.02 (0.81–1.29) | 1.79 (1.37–2.30) | ||
| FLI-NAFLD | |||||
| Event number/total number (%) | 290/54,299 (0.5) | 113/16,515 (0.7) | 35/3,430 (1.0) | ||
| aORb (95% CI) | 1.0 (ref) | 1.31 (1.05–1.65) | 1.89 (1.33–2.70) | ||
| Claims-based NAFLD | |||||
| Event number/total number (%) | 349/65,317 (0.5) | 61/7,053 (0.9) | 28/1,874 (1.5) | ||
| aORb (95% CI) | 1.0 (ref) | 1.46 (1.02–1.90) | 2.60 (1.77–3.89) | ||
| COVID-19-related death | HSI-NAFLD | ||||
| Event number/total number (%) | 21/48,203 (0.04) | 12/18,512 (0.06) | 14/7,529 (0.18) | ||
| aORb (95% CI) | 1.0 (ref) | 1.10 (0.58–2.20) | 4.42 (2.27–8.61) | ||
| FLI-NAFLD | |||||
| Event number/total number (%) | 25/54,299 (0.05) | 20/16,515 (0.1) | 11/3,430 (0.07) | ||
| aORb (95% CI) | 1.0 (ref) | 2.63 (1.48–4.84) | 7.06 (3.49–14.70) | ||
| Claims-based NAFLD | |||||
| Event number/total number (%) | 38/65,317 (0.06) | 1/7,053 (0.01) | 6/1,874 (0.32) | ||
| aORb (95% CI) | 1.0 (ref) | 0.22 (0.02–1.73) | 5.12 (2.23–12.95) | ||
Numbers in bold indicate significant differences (P < 0.05).
COVID-19 = coronavirus disease 2019, NAFLD = non-alcoholic fatty liver disease, FLI = fatty liver index, HSI = hepatic steatosis index, aOR = adjusted odds ratio, CI = confidence interval.
aWe were categorized as severity of liver fibrosis according to the BARD score (0–1, no advanced fibrosis; 2–4, advanced fibrosis); bAdjusted for age (20–39, 40–59, and ≥ 60 years); sex; region of residence (Seoul Capital Area, Daegu/Gyeongbuk area, and other areas); past medical history/comorbidities (tuberculosis, stroke, cardiovascular disease, hypertension, and dyslipidemia); systolic and diastolic blood pressure (continuous); fasting blood glucose (continuous); glomerular filtration rate (≥ 90, 60–89, and ≤ 59 mL/min); household income (low, middle, and high); smoking (never, ex-, and current); alcoholic drinks (< 1, 1–2, 3–4, ≥ 5 days per week); sufficient aerobic activity; current medication for hypertension, dyslipidemia, diabetes mellitus, and cardiovascular disease; cSevere outcomes of COVID-19 comprised requirement of oxygen therapy, admission to the intensive care unit, invasive ventilation, or death.