Association of non-alcoholic fatty liver disease and COVID-19: A literature review of current evidence

Abstract

The coronavirus disease 2019 (COVID-19) pandemic has swept through nations, crippled economies and caused millions of deaths worldwide. Many people diagnosed with COVID-19 infections are often found to develop liver injury, which, in a small portion of patients, progresses to severe liver disease. Liver injury in the form of elevated transaminases, hyperbilirubinemia and alterations in serum albumin has been observed to be higher in patients with severe forms of the disease. Those who already have insult to the liver from chronic disease, such as nonalcoholic fatty liver disease (NAFLD) may be at the greatest disadvantage. The severity of COVID-19 also seems to be driven by the presence of NAFLD and other co-morbidities. About 25% of the global population has NAFLD. With such a widespread prevalence of NAFLD, understanding the disease progression of COVID-19 and the occurrence of liver injury in this vulnerable population assumes great significance. In this review, we present an overview of COVID-19 infection in patients with NAFLD.

COVID-19 infection and body weight: A deleterious liaison in a J-curve relationship

“… 126 Non-alcoholic fatty liver disease (NAFLD) and steatohepatitis (NASH) are features of lipodystrophy 120 , 126 and within this pathogenesis, 122 , 123 lipodystrophy may increase the risk of complications in COVID-19. 127 , 128 …”

The Role of Non-Alcoholic Fatty Liver Disease in Infections

“…This also suggests that people with advanced NAFLD may be even more susceptible to COVID-19 [44]. Additionally, compared to patients without NAFLD, those with NAFLD seem to have a greater chance of disease progression and a longer viral shedding time [45].…”

“…Associations of NAFLD with COVID-19 outcomes might be the result of persistent lipotoxicity, chronic inflammation, insulin resistance, oxidative stress, and immunological response. Additionally, IL-6 (which is typically elevated in people with NAFLD) is overproduced during COVID-19 infection, resulting in a 'cytokine storm' that exacerbates the organism's inflammation [44][45][46][47][48][49][50][51][52].…”