Mounting evidences suggest that maximum susceptibility to get infected with COVID-19 is seen in individuals with pre-existing illness, including metabolic abnormalities. The pandemic characteristics and high-mortality rate of COVID-19 infection have posed few apprehensions about the association between virus pathobiology and components of the metabolic syndrome.

The authors of the study extracted the information from the recent existing literature on COVID-19 acute pandemic and mechanisms of injury in non-alcoholic fatty liver disease (NAFLD), a chronic (non-communicable) metabolic pandemic.

The results showed that severity of COVID-19-infected patients gets increased with underlying metabolic illness, including hypertension, cardiovascular disease, type 2 diabetes, chronic lung diseases such as asthma, chronic obstructive pulmonary disease and emphysema and metabolic syndrome. Metabolic abnormalities mediates expansion of metabolically active fat (overfat condition), which is accompanied with chronic inflammatory changes, development of insulin resistance and accumulation of fat resulting in in the development of NAFLD. The deleterious interaction of inflammatory pathways chronically active in NAFLD and acutely in COVID-19-infected patients can be a causative mechanism for liver damage in a subgroup of patients. This interplay in turn, can precipitate adverse outcomes in metabolically compromised NAFLD patients. Besides, the underlying liver fibrosis can represent an additional and independent risk factor for severe COVID-19 illness, regardless of metabolic comorbidities in a subgroup of patients with NAFLD.

Thus, the study concluded that NAFLD exerts a huge impact in predicting the outcome of COVID-19 illness due to its predominant relationship with comorbidities. It can be postulated that increased liver fibrosis in NAFLD might regulate the prognosis of COVID-19 patients. Therefore, long-term monitoring of post-COVID-19 NAFLD patients is recommended, to assess further worsening of liver damage.

Source: Portincasa P, Krawczyk M, Smyk W, Lammert F, Di Ciaula A. COVID-19 and non-alcoholic fatty liver disease: Two intersecting pandemics. Eur J Clin Invest. 2020 Oct;50(10):e13338.