Evidence mapPaperPMID 41709895Full record

ArticleFrontiers in medicine2026

The impact of the COVID-19 pandemic on liver health: exploring shifts in social and psychosocial determinants of steatosis and fibrosis.

Yuan Zhao, Xuanhui Li, Jiacheng Cheng, Dongyu Hu, Huili Cao, Xiaojuan Wang, Junhua He, Yikun Zhu, Jin Li

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Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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5 · Who and what money

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9 authors.

Yuan ZhaoDepartment of Endocrinology and Metabolism, The Second Hospital of Shanxi Medical University, Shanxi Medical University, Taiyuan, China.
Xuanhui LiSchool of Public Health, Shanxi Medical University, Taiyuan, China.
Jiacheng ChengDepartment of Endocrinology and Metabolism, The Second Hospital of Shanxi Medical University, Shanxi Medical University, Taiyuan, China.
Dongyu HuDepartment of Endocrinology and Metabolism, The Second Hospital of Shanxi Medical University, Shanxi Medical University, Taiyuan, China.
Huili CaoDepartment of Cardiology, The Second Hospital of Shanxi Medical University, Shanxi Medical University, Taiyuan, China.
Xiaojuan WangDepartment of Endocrinology and Metabolism, The Second Hospital of Shanxi Medical University, Shanxi Medical University, Taiyuan, China.
Junhua HeDepartment of Endocrinology and Metabolism, The Second Hospital of Shanxi Medical University, Shanxi Medical University, Taiyuan, China.
Yikun ZhuDepartment of Endocrinology and Metabolism, The Second Hospital of Shanxi Medical University, Shanxi Medical University, Taiyuan, China.
Jin LiDepartment of Endocrinology and Metabolism, The Second Hospital of Shanxi Medical University, Shanxi Medical University, Taiyuan, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background and objective: The COVID-19 pandemic profoundly disrupted social structures, psychological well-being, and lifestyle behaviors, yet the collective impact on steatotic liver disease (SLD) and fibrosis remains unclear. This study aimed to examine whether the relationships of social, psychosocial, and behavioral factors with metabolic dysfunction-associated SLD (MASLD), metabolic alcohol-related liver disease (MetALD), ALD, and liver fibrosis varied across pandemic periods. Methods: We conducted a repeated cross-sectional analysis of 6,090 adults from the National Health and Nutrition Examination Survey (NHANES) 2017-March 2020 (pre-pandemic) and 2021-2023 (pandemic), using vibration-controlled transient elastography and comprehensive social, psychosocial, and lifestyle measures. Weighted prevalence and Firth's logistic regression assessed associations and pandemic interactions via ratios of odds ratios (RORs). Results: Age-standardized MASLD prevalence declined from 32.2% to 28.6%, especially among men, whereas advanced fibrosis nearly doubled from 2.6% to 4.2%, mainly in women. Pandemic-period interactions revealed substantial shifts in risk profiles. Higher income lost its pre-pandemic protective association with MetALD (ROR = 0.21), while unemployment increased MetALD risk in women. Depressive symptoms strengthened ALD risk in men during the pandemic (OR = 5.31; ROR = 6.73), but became less relevant for MetALD, particularly among women. Physical activity, which was previously protective for MASLD and ALD, lost significance post-pandemic. Current smoking markedly amplified ALD risk (OR rising from 3.49 to 17.08), whereas former smoking provided protection against MASLD in men. Dietary inflammation (DII) became inversely associated with fibrosis during the pandemic, and longer weekend sleep offered protective benefits for women. Conclusion: The pandemic period was associated with substantial changes in the epidemiology and psychosocial-behavioral correlates of SLD and fibrosis, with notable sex-specific differences.

Indexed as

ALDCOVID-19MASLDMetALDNHANES

Identifiers

PMID41709895
PMCPMC12909494

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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 Socratic graph.