key: cord-0930165-mbg7kksh
authors: Gao, Hui; Xu, Lei
title: No Association Between Nonalcoholic Fatty Liver Disease and Severe COVID-19? Something We Might Ignore.
date: 2022-04-02
journal: Clin Gastroenterol Hepatol
DOI: 10.1016/j.cgh.2022.03.037
sha: ac862f07afa9dd3aac13dc69fc875b31078256c9
doc_id: 930165
cord_uid: mbg7kksh

nan

I read with interest the article of Li, et al 1 , who performed large-scale two-sample Mendelian randomization analyses to explore the relationship between NAFLD and severe COVID-19. They concluded that there is no evidence supporting that NAFLD is a causal risk factor for severe COVID-19. I have the following queries about their study: Table 5 showed 4.31% of patients with NAFLD were diagnosed as severe COVID-19, higher than those diagnosed as non-severe COVID-19

(1.45%). Besides, the authors performed univariate regression analysis to assess the impact of NAFLD on severe COVID-19 in Figure 2 . The odd ratio (OR) was 3.06 (P= 1.07 × 10 -6 ). The association was significant. After adjusting for the remaining risk factors, the OR was 1.61 (P= 0.08). P-value was close to 0.05 but not significant.

Thus, the author concluded that NAFLD is not an independent risk factor for severe COVID-19. However, these results seem to suggest a link between NAFLD and COVID-19. I suggest that the author should perform multiple models to prove the robustness of this result in the multivariate regression analysis. Supplementary   Table 9 . The data lacks decimal points, which may lead to misinterpretation. Please 

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