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World J Gastroenterol. Apr 28, 2021; 27(16): 1738-1750
Published online Apr 28, 2021. doi: 10.3748/wjg.v27.i16.1738
Coronavirus disease 2019 severity in obesity: Metabolic dysfunction-associated fatty liver disease in the spotlight
Isabela Macedo Lopes Vasques-Monteiro, Vanessa Souza-Mello
Isabela Macedo Lopes Vasques-Monteiro, Vanessa Souza-Mello, Anatomy, Rio de Janeiro State University, Rio de Janeiro 20551030, Brazil
Isabela Macedo Lopes Vasques-Monteiro, Food Science and Technology, Federal University of the State of Rio de Janeiro, Rio de Janeiro 22290250, Brazil
Vanessa Souza-Mello, Laboratory of Morphometry, Metabolism, and Cardiovascular Diseases, Biomedical Center, Institute of Biology, Anatomy Department, Rio de Janeiro State University, Rio de Janeiro 20551030, Brazil
Author contributions: Souza-Mello V conceived the idea for the manuscript; Vasques-Monteiro IML and Souza-Mello V performed the literature search and data analysis and drafted the manuscript; Vasquez-Monteiro IML designed the figures; Souza-Mello V critically revised the work; all authors read and approved the final version of the manuscript.
Supported by Conselho Nacional de Desenvolvimento Científico e Tecnológico (Brazil), No. 305867/2017-2; and Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro, No. E-26/202.657/2018.
Conflict-of-interest statement: The authors have nothing to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Vanessa Souza-Mello, PhD, Associate Professor, Laboratory of Morphometry, Metabolism, and Cardiovascular Diseases, Biomedical Center, Institute of Biology, Anatomy Department, Rio de Janeiro State University, Blvd. 28 de setembro 87, Rio de Janeiro 20551030, Brazil. souzamello.uerj@gmail.com
Received: January 10, 2021
Peer-review started: January 10, 2021
First decision: February 11, 2021
Revised: February 15, 2021
Accepted: March 22, 2021
Article in press: March 22, 2021
Published online: April 28, 2021
Processing time: 100 Days and 16.4 Hours
Core Tip

Core Tip: It is notorious that obesity represents a risk for coronavirus disease 2019 (COVID-19) severity. However, COVID-19 often causes liver alterations or provokes the progression of pre-existing liver diseases. This review outlines the role of metabolic dysfunction-associated fatty liver disease in COVID-19 severity. The evidence available thus far supports the notion that metabolic dysfunction-associated fatty liver disease represents a more intense risk than obesity for hospitalization, extended viral shedding, and death. A pro-inflammatory state with inflammasome activation, implying increased susceptibility to cytokine storm syndrome, underlies these findings and emerges as, in addition to massive vaccination of subjects with liver diseases, potential targets for therapeutic strategies.