https://pubmed.ncbi.nlm.nih.gov/36694381/ Covid-19
Obesity (Silver Spring). 2023 Jan 24.
doi: 10.1002/oby.23728. Online ahead of print.

Rising NAFLD and Metabolic Severity During the Sars-CoV-2 Pandemic among Children with Obesity in the United States

Aaron L Slusher 1, Pamela Hu 1, Stephanie Samuels 1, Fuyuze Tokoglu 2, Jessica Lat 1, Zhongyao Li 1, Michele Alguard 1, Jordan Strober 3, Daniel Vatner 3, Veronika Shabanova 1, Sonia Caprio 1

Abstract
Background: Non-alcoholic fatty liver disease (NAFLD), the most common liver disease among youth with obesity, precedes more severe metabolic and liver diseases. However, the impact of the Sars-CoV-2 global pandemic on the prevalence and severity of NAFLD and the associated metabolic phenotype among youth with obesity is unknown.

Methods: Subjects were recruited from the Yale Pediatric Obesity Clinic during (August 2020 - May 2022) and compared to a frequency matched control group of youth with obesity studied before the Sars-CoV-2 global pandemic (January 2017 - November 2019). Glucose metabolism differences were assessed during an extended 180-min oral glucose tolerance test. MRI-Proton Density Fat Fraction was utilized to determine intrahepatic fat content NAFLD (PDFF ≥ 5.5).

Results: NAFLD prevalence increased in subjects prior to (37.3%) verses during the Sars-CoV-2 pandemic (60.9%), with higher PDFF values observed in NAFLD subjects (PDFF ≥ 5.5%) during versus pre-pandemic. An increase in visceral adipose tissue and a hyperresponsiveness in insulin secretion during the OGTT was also observed.

Conclusions: Hepatic health differences were likely exacerbated by environmental and behavioral changes associated with the pandemic, which are critically important for clinicians to consider when engaging in patient care to help minimize the future risk for metabolic perturbations.