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World J Hepatol. Aug 27, 2021; 13(8): 916-925
Published online Aug 27, 2021. doi: 10.4254/wjh.v13.i8.916
Association of non-alcoholic fatty liver disease and COVID-19: A literature review of current evidence
Prajna Anirvan, Shivaram P Singh, Alexa Giammarino, Sanjaya K Satapathy
Prajna Anirvan, Shivaram P Singh, Department of Gastroenterology, Sriram Chandra Bhanj Medical College and Hospital, Cuttack 753007, Odisha, India
Alexa Giammarino, Department of Internal Medicine, Donald and Barbara Zucker School of Medicine at Hofstra, Manhasset, NY 11030, United States
Sanjaya K Satapathy, Division of Hepatology at Sandra Atlas Bass Center for Liver Diseases and Transplantation, Donald and Barbara Zucker School of Medicine at Hofstra, Manhasset, NY 11030, United States
Author contributions: Singh SP and Satapathy SK contributed to conception and design; Singh SP, Satapathy SK, Anirvan P and Giammarino A contributed collection and assembly of data; Singh SP and Satapathy SK finished data analysis and interpretation; all authors wrote the manuscript and completed final approval of the manuscript.
Conflict-of-interest statement: None of the authors have any conflict of interest to declare.
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: Sanjaya K Satapathy, FAASLD, AGAF, FACG, FASGE, MBBS, MD, MS, Attending Doctor, Director, Professor, Division of Hepatology at Sandra Atlas Bass Center for Liver Diseases and Transplantation, Donald and Barbara Zucker School of Medicine at Hofstra, Northwell Health, 400 Community Drive, Manhasset, NY 11030, United States. ssatapat@northwell.edu
Received: May 7, 2021
Peer-review started: May 7, 2021
First decision: June 15, 2021
Revised: June 21, 2021
Accepted: August 4, 2021
Article in press: August 4, 2021
Published online: August 27, 2021
Processing time: 105 Days and 4.5 Hours
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.

Keywords: SARS-CoV-2; Fatty liver; Mitochondria; Nitrosative stress; Oxidative stress; COVID-19; Metabolic associated fatty liver disease; Nonalcoholic fatty liver disease; Progressive liver disease; Nonalcoholic steatohepatitis

Core Tip: Liver injury in the form of elevated transaminases and hyperbilirubinemia in coronavirus disease 2019 (COVID-19) may be attributed to multiple factors, including the presence of pre-existing liver disease. The presence of nonalcoholic fatty liver disease (NAFLD) in patients with COVID-19 is likely to make them susceptible to severe forms of liver injury. Given the high prevalence of NAFLD worldwide, it is important to understand the implications of COVID-19 in such patients including role of comorbidities, disease progression, and the severity of COVID-19.