Published online Jun 16, 2021. doi: 10.12998/wjcc.v9.i17.4133
Peer-review started: January 13, 2021
First decision: February 10, 2021
Revised: February 24, 2021
Accepted: April 26, 2021
Article in press: April 26, 2021
Published online: June 16, 2021
Processing time: 132 Days and 15.4 Hours
Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a global pandemic, affecting all the individuals across the planet. COVID-19 has gained significant attention due to its high prevalence among individuals with diabetes, nonalcoholic fatty liver disease (NAFLD), and metabolic syndrome. NAFLD is the hepatic manifestation of metabolic syndrome and can be associated with a high risk of developing type 2 diabetes. The association of COVID-19 and NAFLD has also gained more attention because NAFLD is highly associated with the epidemic of obesity. NAFLD is a potential risk factor for SARS-CoV-2 infection and severe COVID-19, independent of metabolic syndrome. Importantly, it is not yet clear whether the epidemics of obesity and NAFLD have perpetuated the current pandemic of COVID-19. Further research is urgently needed to assess the following: (1) Whether NAFLD is a high risk factor for SARS-CoV-2 infection; (2) Whether NAFLD is associated with the severe form of COVID-19; and (3) Whether the presence of NAFLD can explain the racial variation in the morbidity and mortality associated with COVID-19. This review summarizes the interactions between COVID-19 and NAFLD, mechanism of liver injury by COVID-19, and effect of lockdown due to COVID- 19 on patients with NAFLD.
Core Tip: Earlier studies suggested that individuals most vulnerable to severe acute respiratory syndrome coronavirus 2 infection suffer from pre-existing disease, including nonalcoholic fatty liver disease (NAFLD). There is an interwoven relationship between NAFLD and the associated high-risk factors for coronavirus disease 2019 (COVID-19). NAFLD can increase risk of infection, lung injury, cardiac impairment, and difficulty with respiratory ventilation, and can be associated with higher risk for COVID-19, especially in the presence of liver fibrosis. The association between high production of interleukin-6 in both NAFLD and COVID-19 merits further research to determine whether NAFLD is directly involved in the cytokine storms.