THE IMPACT OF COLON DYSBIOSIS ON THE PROGRESSION OF COGNITIVE IMPAIRMENT IN CHILDREN WITH NON-ALCOHOLIC FATTY LIVER DISEASE AND OBESITY IN COVID-19
DOI:
https://doi.org/10.11603/1811-2471.2024.v.i4.15033Keywords:
children, non-alcoholic fatty liver disease, obesity, cognitive impairment, speech and language development disorder, diagnosis, CASD testing, autism spectrum disorders, lipid metabolism, colon dysbiosis, COVID-19Abstract
SUMMARY. The study of the characteristics of cognitive impairment, as well as the factors contributing to their formation/progression in children with overweight and non-alcoholic fatty liver disease (NAFLD) during the COVID-19 pandemic is an extremely important and relevant issue of medicine and public health.
The aim – to investigate the features of the progression of cognitive changes in obese children with COVID-19 depending on the severity of colon dysbiosis in NAFLD.
Material and Methods. The study included 108 children with NAFLD and obesity with speech and language development disorders (SLD). The children were divided into two clinical groups: group 1 (n=58) included children who had COVID-19, and group 2 consisted of 50 children who didn’t have COVID-19. CASD testing was performed to determine cognitive impairment in children with NAFLD and obesity. The children underwent a study of the species and quantitative composition of the colon microflora (CM) to determine colon dysbiosis (CD).
Results. In children of group I, a significant decrease in the number and percentage of Lactobacillus, Bifidobacterium, Escherichia was found, accompanied by a significant increase in the number of Enterobacter, Citrobacter, Staphylococcus, Klebsiella, Clostridium, Proteus and Candida after determining the microbial composition of the gastrointestinal microflora. In children with SLD in obesity and NAFLD who had COVID-19, grade III CD was more often detected (in 37.9 % of children – p<0.01), while in children of group II – grade I DC (in half of the subjects – p<0.01). At the same time, autism spectrum disorders (ASD) in children with SLD in obesity and NAFLD depend on the severity of CD. Explicit dysbiotic changes found in children of group I after COVID-19 affect the degree of cognitive impairment in the examined children.
Conclusions. In children with SLD with NAFLD and obesity, CD was detected, the severity of which progresses in children after COVID-19.
A direct correlation was established between the degree of SLD according to CASD in children with ASD with obesity and NAFLD, mainly after coronavirus disease.
References
Eslam, M., Newsome, P.N., Sarin, S.K., Anstee, Q.M., Targher, G., Romero-Gomez, M., Zelber-Sagi, S., Wai-Sun Wong, V., Dufour, J.F., Schattenberg, J.M., Kawaguchi, T., Arrese, M., Valenti, L., Shiha, G., Tiribelli, C., Yki-Järvinen, H., Fan, J.G., Grønbæk, H., Yilmaz, Y., Cortez-Pinto, H., Oliveira, C.P., Bedossa, P., Adams, L.A., Zheng, M.H., Fouad, Y., Chan, W.K., Mendez-Sanchez, N., Ahn, S.H., Castera, L., Bugianesi, E., Ratziu, V., George, J. (2020). A new definition for metabolic dysfunction-associated fatty liver disease: An international expert consensus statement. J Hepatol., 73 (1), 202-209. DOI: 10.1016/j.jhep.2020.03.039 DOI: https://doi.org/10.1016/j.jhep.2020.03.039
Chalasani, N., Younossi, Z., Lavine, J.E., Charlton, M., Cusi, K., Rinella, M., Harrison, S.A., Brunt, E.M., Sanyal, AJ. (2018). The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases. Hepatology, 67 (1), 328-357. DOI: 10.1002/hep.29367 DOI: https://doi.org/10.1002/hep.29367
Moore, J.B. (2022). COVID-19, childhood obesity, and NAFLD: colliding pandemics. Lancet Gastroenterol Hepatol., 7 (6), 499-501. DOI: 10.1016/S2468-1253(22)00100-5. PMID: 35550045; PMCID: PMC9084622. DOI: https://doi.org/10.1016/S2468-1253(22)00100-5
Browne, N.T., Snethen, J.A., Greenberg, C.S., Frenn, M., Kilanowski, J.F., Gance-Cleveland, B., Burke, P.J., Lewandowski, L. (2021). When Pandemics Collide: The Impact of COVID-19 on Childhood Obesity. J Pediatr Nurs, 56, 90-98. DOI: 10.1016/j.pedn.2020.11.004 DOI: https://doi.org/10.1016/j.pedn.2020.11.004
Moore, J.B., Evans, C.E. (2020). Obese and hungry: two faces of a nation. BMJ, 6, 370, m3084. DOI: 10.1136/bmj.m3084 DOI: https://doi.org/10.1136/bmj.m3084
Avittan, H., Kustovs, D. (2023). Cognition and Mental Health in Pediatric Patients Following COVID-19. Int J Environ Res Public Health, 20 (6), 5061. DOI: 10.3390/ijerph20065061 DOI: https://doi.org/10.3390/ijerph20065061
Di Sessa, A., Lanzaro, F., Zarrilli, S., Picone, V., Guarino, S., Miraglia Del Giudice, E., Marzuillo, P. (2021). COVID-19 and pediatric fatty liver disease: Is there interplay? World J Gastroenterol., 27 (22), 3064-3072. DOI: 10.3748/wjg.v27.i22.3064 DOI: https://doi.org/10.3748/wjg.v27.i22.3064
Soriano, J.B., Murthy, S., Marshall, J.C., Relan, P., Diaz, J.V. (2022). WHO Clinical Case Definition Working Group on Post-COVID-19 Condition. A clinical case definition of post-COVID-19 condition by a Delphi consensus. Lancet Infect Dis., 22 (4), e102-e107. DOI: 10.1016/S1473-3099(21)00703-9 DOI: https://doi.org/10.1016/S1473-3099(21)00703-9
