COVID-19 is currently the leading public health problem, associated with a high risk of complications and death in risk groups of patients. Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease with a prevalence of 30% in the Western population and is also recognized as an independent risk factor for the development of severe COVID-19. In the pathogenesis of COVID-19, the key role is played by the hyperreactivity of the immune response, the so-called cytokine storm leading to the development of severe forms of pneumonia, acute respiratory and multiorgan failure. The aim of this study is to investigate the clinical course, outcomes, and profile of inflammatory response in patients with COVID-19 and NAFLD.
SARS-CoV-2 virus infection is currently the leading public health problem, associated with a high risk of complications and death in at-risk groups. Risk factors for the development of severe forms of COVID-19 include components of the metabolic syndrome (obesity, diabetes, dyslipidemia, and arterial hypertension), which are also associated with the development of nonalcoholic fatty liver disease (NAFLD). According to previously published, but mostly retrospective studies, NAFLD is a possible risk factor for the development of severe COVID-19. . In the pathogenesis of COVID-19, the key role is played by the hyperreactivity of the immune response, the so-called cytokine storm. According to recent research, activation of the Th17 system could play a key role in the regulation of this excessive inflammatory response. Furthermore, Th17 lymphocytes and cytokines are important in the development and progression of NAFLD. The question is whether, due to Th17 hyperreactivity, patients with NAFLD are at higher risk of developing severe forms of the disease and what is the profile of the Th17 immune response to SARS-CoV-2 infection in this group of patients.
Study Type
OBSERVATIONAL
Enrollment
120
Screening for the components of metabolic syndrome
Anthropometric measures including height, weight, waist circumference and hip circumference will be measured in all patients. Results of the routine laboratory tests as part of the standard diagnostic procedure will be collected: CRP, leukocyte count, ratio neutrophils and lymphocytes, hemoglobin, platelet count, urea, creatinine, bilirubin, AST, ALT, GGT, ALP, albumins, fasting glucose.
The degree of steatosis will be estimated using the ultrasound and a method for grading steatosis will be measuring the degree of ultrasound attenuation by hepatic fat using a process based on simultaneous transient elastography (TE) which measures the degree of steatosis.
University Hospital for Infectious Diseases Zagreb
Zagreb, Croatia
Th17 cytokines concentrations
Measurement of Th17 cytokines concentration in serum of patients by multiplex technology
Time frame: Day of hospital admission
Staging of liver steatosis
The degree of steatosis will be estimated using the controlled attenuation parameter (CAP) in patients with NAFLD.
Time frame: Day of hospital discharge (expected maximum of 28 days)
Duration of hospitalization
Days of hospitalization
Time frame: Day of hospital discharge (expected maximum of 28 days)
Remission of respiratory symptoms
Time to independence from oxygen therapy in days
Time frame: Day of hospital discharge (expected maximum of 28 days)
28 days survival
Number of subjects surviving at 28 days from hospitalization
Time frame: Day of hospital discharge (expected maximum of 28 days)
Rate of high flow oxygen therapy or non-invasive ventilation
Requirement for high flow oxygen therapy during the initial hospitalisation
Time frame: Day of hospital discharge (expected maximum of 28 days)
Secondary infections
Presence/absence of secondary infection during hospitalization
Time frame: Day of hospital discharge (expected maximum of 28 days)
Rate of invasive mechanical ventilation
Requirement of invasive mechanical ventilation
Time frame: Day of hospital discharge (expected maximum of 28 days)
Rate of pulmonary thromboembolism
Presence of pulmonary thromboembolism diagnosed with MSCT pulmonary angiography on clinical suspicion
Time frame: Day of hospital discharge (expected maximum of 28 days)
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