Evidence map›Paper›PMID 40208509›Full record

ArticleInfection2025

Possible link between steatotic liver diseases, severe COVID-19 and cognitive impairment in post-COVID-19 syndrome.

Philipp A Reuken, Freya Wagner, Kathrin Finke, Christina Lemhöfer, Christian Puta, Sven Stengel, André Scherag, Jan-Christoph Lewejohann, Andreas Stallmach, Stefanie Quickert

Abstract read
In one paragraph

Article in Infection, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Philipp A Reuken *Department of Internal Medicine IV (Gastroenterology, Hepatology, and Infectious Diseases), Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany.ORCID http://orcid.org/0000-0002-7696-475X
Freya Wagner *Department of Internal Medicine IV (Gastroenterology, Hepatology, and Infectious Diseases), Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany.
Kathrin FinkeDepartment of Internal Medicine IV (Gastroenterology, Hepatology, and Infectious Diseases), Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany.ORCID http://orcid.org/0000-0001-8546-7141
Christina LemhöferInstitute of Physical and Rehabilitation Medicine, Jena University Hospital, Jena, Germany.ORCID http://orcid.org/0000-0002-6206-4064
Christian PutaDepartment of Internal Medicine IV (Gastroenterology, Hepatology, and Infectious Diseases), Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany.ORCID http://orcid.org/0000-0003-3936-4605
Sven StengelDepartment of Neuropediatrics, Jena University Hospital, Jena, Germany.
André ScheragInstitute of Medical Statistics, Computer and Data Sciences, Jena University Hospital, Jena, Germany.ORCID http://orcid.org/0000-0002-9406-4704
Jan-Christoph LewejohannDepartment of Emergency Medicine, Jena University Hospital, Jena, Germany.ORCID http://orcid.org/0000-0003-2002-7131
Andreas StallmachDepartment of Internal Medicine IV (Gastroenterology, Hepatology, and Infectious Diseases), Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany.ORCID http://orcid.org/0000-0002-6101-5244
Stefanie QuickertDepartment of Internal Medicine IV (Gastroenterology, Hepatology, and Infectious Diseases), Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany. stefanie.quickert@med.uni-jena.de.ORCID http://orcid.org/0009-0009-9391-4111

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeSteatotic liver diseases (SLD) have become more prevalent over the last decade and are associated not only with cardiometabolic diseases but also with psychological symptoms (depression, fatigue). These symptoms are also common in post-COVID syndrome (PCS). Therefore, the aim of the study was to analyze the burden of SLD in PCS patients.

methodsWe systematically screened all PCS patients from our post-COVID outpatient clinic using transient elastography, structured questionnaires for neurocognitive evaluation and blood sample analysis. Controls without PCS and without known liver diseases were also recruited and assessed with the same approach.

results560 PCS patients and 103 healthy controls were included. The overall prevalence of SLD was high in both cohorts (57 vs. 53%). PCS patients with SLD were more frequently male (41 vs. 24%), older (52 vs. 44 years) and had more cardiometabolic diseases (87.0 vs. 46.4%). Cognitive impairment was more related to SLD in PCS patients than in the no-SLD group (OR: 1.68, CI: 1.14-2.46, p = 0.008). The presence of SLD was related to severe COVID-19 with hospitalization (OR: 2.91, CI: 1.85-4.56, p < 0.001). Within 1 year of the follow-up, 152 of 289 patients described a resolution in PCS irrespective of the presence or absence of SLD (log-rank p = 0.96).

conclusionsSLD is associated with severe COVID-19 and cognitive dysfunction in PCS. Longitudinal studies are needed to assess the role of hepatic steatosis, development of post-acute infection regulation (e.g., SARS-CoV-2) and to differentiate between SLD-associated symptoms and PCS.

Indexed as

Cognitive DysfunctionCOVID-19Fatty LiverAdultAgedFemaleHumansMaleMiddle AgedPrevalenceSARS-CoV-2Cognitive dysfunctionFatigueHepatic steatosisPost-COVIDSLD

Identifiers

PMID40208509
PMCPMC12460423

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.