Table 2.

Summary of studies addressing Covid-19 outcomes in alcohol-related liver disease, autoimmune liver disease, non-alcoholic fatty liver disease, and hepatitis B infection

Study	Aim	Design	Location	Number of patients included	Main results
Alcohol-related liver disease
Kim et al. (2021)	To identify the factors associated with adverse outcomes in patients with CLD who acquire COVID-19	Multicentre observational study	North America	COVID-19 with ALD (n = 94)	ALD independently predicted all-cause moryality (HR: 2.42; 95% CI 1.29–4.55; p = 0.006)
Marjot et al. (2021)	To determine the impact of COVID-19 on patients with pre-existing liver disease	Multinational cohort study	29 countries	Alive COVID-19 with ALD (n = 115); Dead COVID-19 with ALD (n = 64)	ALD was an independent risk factor for death from COVID-19 (adjusted OR 1.79; 95% CI1.03–3.13; p = 0.040)
Autoimmune liver disease
Di Giorgio et al. (2020)	To explore the clinical features of SARS-CoV-2 infection in patients with AILD under immunosuppression	Phone-based survey	Italy	COVID-19 with immunosuppressed AILD (n = 4); immunosuppressed AILD only (n = 148)	Immunosuppression was not related to severe COVID-19 infection in patients with AILD
Efe et al. (2021)	To assess the clinical characteristics and outcomes of patients with AIH infected with COVID‐19	Multicentre cohort study	Europe and United States	COVID-19 with AIH (n = 110; 102 under immunosuppression)	Immunosuppression was not related to adverse outcomes of COVID-19 in patient with AIH AIH was not associated with higher hospitalisation (46.4% vs. 50.0%; p = 0.560), need for supplemental oxygen (38.2% vs. 42.2%; p = 0.553), all-cause mortality (10.0% vs. 11.5%; p = 0.852), or severe COVID-19 (15.5% vs. 20.2%; p = 0.231)
Non-alcoholic fatty liver disease
Ji et al. (2020)	To examine the liver injury patterns and implication of NAFLD on clinical outcomes in Chinese patients with COVID-19	Hospital-based retrospective study	China	Stable COVID-19 (n = 163); stable COVID-19 with NAFLD (n = 42); progressive COVID-19 (n = 39); progressive COVID-19 with NAFLD (n = 34)	NAFLD was significantly associated with COVID-19 progression (OR 6.4; 95% CI 1.5–31.2). Patients with NAFLD presented higher risk of developing abnormal liver function from admission to discharge (11.1% vs. 70%; p < 0.0001) and longer viral shedding time (12.1 ± 4.4 days vs. 17.5 ± 5.2 days; p < 0.0001)
Zheng et al. (2020)	To investigate the association between MAFLD and COVID-19 severity	Multicentre retrospective cohort study	China	Obese COVID-19 with MAFLD (n = 45); non-obese COVID-19 with MAFLD (n = 21); Severe COVID-19 with obese and MAFLD (n = 17); severe COVID-19 with non-obese and MAFLD (n = 2)	Obese MAFLD patients had a sixfold increased risk of developing severe COVID-19 compared to non-obese MAFLD patients (adjusted OR 6.32; 95% CI 1.16–34.54; P = 0.033)
Targher et al. (2020)	To study whether MAFLD with increased non-invasive liver fibrosis scores are at higher risk of severe illness from COVID-19	Multicentre retrospective cohort study	China	COVID-19 with MAFLD and low FIB-4 (n = 44); with intermediate FIB-4 (n = 36); with high FIB-4 (n = 14)	Severe COVID-19 was associated with presence of intermediate (OR 4.32; 95% CI 1.94–9.59) or high FIB-4 scores (OR 5.73; 95% CI 1.84–17.9) among patients with MAFLD
Hepatitis B virus
Liu et al. (2020)	To investigate liver function changes of COVID-19 patients with HBV infection, and how SARS-CoV-2 infection affects the course of chronic HBV infection	Retrospective cohort study	China	COVID-19 without chronic HBV infection (n = 51); COVID-19 with chronic HBV infection (n = 20)	Severe COVID-19 was similar in patients with and without HBV infection (30% vs. 31.4%; p = 0.97). Patient with HBV infection did not show longer median time to SARS-CoV-2 clearance compared with patients without HBV (21 days vs. 14 days; p = 0.1)
Chen et al. (2020)	To investigate the clinical characterizes of patients coinfected with SARS-CoV-2 and HBV	Hospital-based retrospective study	China	COVID-19 without HBV infection (n = 108); COVID-19 with HBV infection (n = 15)	HBV infection was associated with higher mortality rate compared to patients without HBV infection (13.3% vs. 2.8%)

ARLD alcohol-related liver disease, AILD autoimmune liver disease, AIH autoimmune hepatitis, CLD chronic liver disease, NAFLD non-alcoholic fatty liver disease, MAFLD metabolic associated fatty liver disease, HBV Hepatitis B virus, OR odds ratio, CI confidence interval, HR hazard ratio, FIB-4 fibrosis-4

References: Kim D, Adeniji N, Latt N, et al. Predictors of Outcomes of COVID-19 in Patients With Chronic Liver Disease: US Multi-center Study. Clin Gastroenterol Hepatol. 2021;19(7):1469–1479.e19; Di Giorgio A, Nicastro E, Speziani C, et al. Health status of patients with autoimmune liver disease during SARS-CoV-2 outbreak in northern Italy. J Hepatol. 2020;73(3):702–705; Efe C, Dhanasekaran R, Lammert C, et al. Outcome of COVID-19 in Patients With Autoimmune Hepatitis: An International Multicenter Study. Hepatology. 2021;73(6):2099–2109; Ji D, Qin E, Xu J, et al. Non-alcoholic fatty liver diseases in patients with COVID-19: A retrospective study. J Hepatol. 2020;73(2):451–453; Zheng KI, Gao F, Wang XB, et al. Letter to the EditOR Obesity as a risk factor for greater severity of COVID-19 in patients with metabolic associated fatty liver disease. Metabolism. 2020;108:154244; Targher G, Mantovani A, Byrne CD, et al. Risk of severe illness from COVID-19 in patients with metabolic dysfunction-associated fatty liver disease and increased fibrosis scores. Gut. 2020;69(8):1545–1547; Liu J, Wang T, Cai Q, et al. Longitudinal changes of liver function and hepatitis B reactivation in COVID-19 patients with pre-existing chronic hepatitis B virus infection. Hepatol Res. 2020;50(11):1211–1221; Chen X, Jiang Q, Ma Z, et al. Clinical Characteristics of Hospitalized Patients with SARS-CoV-2 and Hepatitis B Virus Co-infection. Virol Sin. 2020;35(6):842–845