{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T12:30:52Z","timestamp":1780144252612,"version":"3.54.0"},"reference-count":70,"publisher":"Baishideng Publishing Group Inc.","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World J Hepatol"],"abstract":"<jats:p>BACKGROUND<\/jats:p>\n                  <jats:p>Dynamic alterations in lymphocyte subsets demonstrate significant correlations with clinical disease severity in patients with coronavirus disease 2019 (COVID-19). As the most prevalent chronic liver disease globally, non-alcoholic fatty liver disease (NAFLD) exhibits distinct chronic inflammatory and immunometabolic disturbances that may substantially affect immune response patterns in COVID-19 patients. Nevertheless, the characteristics of lymphocyte subset dynamics and their clinical implications in COVID-19-NAFLD remain to be fully elucidated.<\/jats:p>\n                  <jats:p>AIM<\/jats:p>\n                  <jats:p>To characterize the dynamic changes in lymphocyte subsets among COVID-19 patients with NAFLD, in order to delineate their immunological profiles and inform clinical management strategies.<\/jats:p>\n                  <jats:p>METHODS<\/jats:p>\n                  <jats:p>The cohort study compared lymphocyte subpopulations in 858 COVID-19 patients and 670 COVID-19-NAFLD patients at admission, discharge, and 2-week\/4-week post-discharge follow-ups.<\/jats:p>\n                  <jats:p>RESULTS<\/jats:p>\n                  <jats:p>Compared to COVID-19 patients without NAFLD, NAFLD-comorbid patients demonstrated persistently elevated CD3+CD4+ counts as well as lymphocyte counts and percentages at admission and at the 2-week and 4-week follow-ups post-discharge (all P  &lt; 0.05). Among COVID-19-NAFLD patients, those aged \u2265 60 years had significantly lower CD3+ counts, CD3+CD4+ counts, CD3+CD8+ counts, lymphocyte counts and percentages, and CD19+ counts and percentages at all assessed time points (all P  &lt; 0.05); significant liver fibrosis correlated with reduced CD3+CD4+ counts, CD3+CD8+ counts, and lymphocyte counts and percentages across all time points (all P  &lt; 0.05); multimorbidity (\u2265 3 comorbidities) exacerbated immune imbalance, marked by elevated CD3+CD4+ percentages and CD56+ counts at admission, increased CD3+CD4+ counts, lymphocyte counts, and CD19+ counts and percentages at discharge, as well as sustained increases in CD3+CD4+ counts at the 2-week follow-up and higher CD3+CD4+ percentages at the 4-week post-discharge follow-up (all P  &lt; 0.05); and obesity and elevated liver enzymes were independently linked to higher CD3+CD4+ counts, CD19+ counts, and lymphocyte counts at all post-admission evaluations (from discharge through the 4-week follow-up) (all P  &lt; 0.05).<\/jats:p>\n                  <jats:p>CONCLUSION<\/jats:p>\n                  <jats:p>Age, liver fibrosis, comorbidities, obesity, liver enzyme abnormalities, vaccination status, low-density lipoprotein cholesterol, and hemoglobin A1c significantly modulate immune responses in COVID-19-NAFLD patients, warranting targeted clinical attention. Furthermore, patients with uncomplicated NAFLD (including lean NAFLD) also require particular clinical attention to mitigate risks of immune imbalance.<\/jats:p>","DOI":"10.4254\/wjh.v18.i2.113004","type":"journal-article","created":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T02:36:03Z","timestamp":1770863763000},"source":"Crossref","is-referenced-by-count":1,"title":["Dynamic immune response and its influencing factors in COVID-19 patients with non-alcoholic fatty liver disease: A cohort study"],"prefix":"10.4254","volume":"18","author":[{"given":"Pan","family":"Yan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-Yan","family":"Yuan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-Juan","family":"Lan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-Ping","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Da-Feng","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2060","published-online":{"date-parts":[[2026,2,27]]},"reference":[{"key":"B1","unstructured":"World Health Organization.   COVID-19 Cases, World. [cited 3 August 2025]. Available from: https:\/\/covid19.who.int\/"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.26050"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.isci.2020.101645"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.34172\/aim.2021.23"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/j.prp.2020.153097"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v29.i2.367"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.26237"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/j.dsx.2020.04.018"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1111\/eci.13338"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1111\/irv.12618"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2020-320953"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.14218\/JCTH.2020.00018"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.3390\/medicina57101057"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1007\/s12072-009-9158-6"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.12998\/wjcc.v8.i19.4303"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmet.2015.04.004"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgac137"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0270418"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1002\/path.1570"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2020.08.2065"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1038\/s41577-020-0331-4"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1016\/j.ebiom.2020.102763"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2018.01.046"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1111\/liv.14484"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2020.02037"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2020.04.004"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiaa150"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1172\/jci.insight.137799"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1016\/j.cca.2020.05.019"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa248"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2020.03.054"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2021.636768"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30566-3"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1172\/jci.insight.139024"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.899930"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.51821\/85.1.9156"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.1016\/j.ebiom.2023.104912"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000020616"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1177\/2050640619865133"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1111\/jvh.12682"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1111\/jvh.12842"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.1016\/j.joim.2020.03.001"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.1002\/hep.510240201"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2022.10.035"},{"key":"B45","doi-asserted-by":"publisher","DOI":"10.1002\/hcs2.36"},{"key":"B46","doi-asserted-by":"publisher","DOI":"10.3760\/cma.j.issn.1007-3418.2018.03.008"},{"key":"B47","doi-asserted-by":"publisher","DOI":"10.1002\/hep.30506"},{"key":"B48","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2020.597648"},{"key":"B49","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-immunol-032414-112056"},{"key":"B50","doi-asserted-by":"publisher","DOI":"10.1126\/sciimmunol.abf6692"},{"key":"B51","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2014.07.056"},{"key":"B52","doi-asserted-by":"publisher","DOI":"10.1038\/s41575-019-0210-2"},{"key":"B53","doi-asserted-by":"publisher","DOI":"10.1016\/j.freeradbiomed.2018.06.015"},{"key":"B54","doi-asserted-by":"publisher","DOI":"10.1002\/hep.26749"},{"key":"B55","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccell.2014.09.003"},{"key":"B56","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmgh.2021.08.019"},{"key":"B57","doi-asserted-by":"publisher","DOI":"10.1080\/00325481.2020.1855921"},{"key":"B58","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2023.1224340"},{"key":"B59","doi-asserted-by":"publisher","DOI":"10.1172\/JCI170118"},{"key":"B60","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2020.01142"},{"key":"B61","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.967410"},{"key":"B62","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2017.00290"},{"key":"B63","doi-asserted-by":"publisher","DOI":"10.1016\/j.medin.2009.12.005"},{"key":"B64","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.051299"},{"key":"B65","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001053"},{"key":"B66","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2019.00071"},{"key":"B67","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.160.20.3082"},{"key":"B68","doi-asserted-by":"publisher","DOI":"10.1159\/000443073"},{"key":"B69","doi-asserted-by":"publisher","DOI":"10.1111\/jdi.13002"},{"key":"B70","doi-asserted-by":"publisher","DOI":"10.1111\/j.1432-2277.2009.00927.x"}],"container-title":["World Journal of Hepatology"],"original-title":[],"link":[{"URL":"https:\/\/www.wjgnet.com\/1948-5182\/full\/v18\/i2\/113004.htm","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.wjgnet.com\/1948-5182\/full\/v18\/i2\/113004.htm","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T02:36:13Z","timestamp":1770863773000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.wjgnet.com\/1948-5182\/full\/v18\/i2\/113004.htm"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,27]]},"references-count":70,"journal-issue":{"issue":"2"},"alternative-id":["113004"],"URL":"https:\/\/doi.org\/10.4254\/wjh.v18.i2.113004","relation":{},"ISSN":["1948-5182"],"issn-type":[{"value":"1948-5182","type":"print"}],"subject":[],"published":{"date-parts":[[2026,2,27]]}}}