General Medicine and Metabolic Diseases, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico , Milan, Italy.
Department of Pathophysiology and Transplantation, Università Degli Studi Di Milano , Milano, Italy.
Expert Rev Gastroenterol Hepatol. 2020 Oct;14(10):867-872. doi: 10.1080/17474124.2020.1801417. Epub 2020 Aug 4.
The pandemic Sars-CoV-2 infection represents a dramatic health challenge worldwide. Pneumonia is considered the major damage caused by the virus. However, recent data have highlighted the impact of the Sars-CoV-2 related disease namely COVID-19 on the liver. Hepatic abnormalities significantly increase during COVID-19 and a more severe infection occurs in patients with pre-existing liver diseases, among which the most frequent is metabolic-associated fatty liver disease (MAFLD). It has been described that MAFLD patients had a higher risk of progression to severe COVID-19, higher abnormal liver tests and longer viral shedding time. The presence of fibrosis in MAFLD patients is another risk factor for severity of COVID-19. Due to the overgrowing prevalence of MAFLD, it could be speculated that a large proportion of the population might be at risk of severe COVID-19 and the identification of these patients possibly by using liver enzymes as risk predictors may be crucial for an early diagnosis and for the management of the infection.
新冠病毒（Sars-CoV-2）疫情是对全球健康的重大挑战。肺炎被认为是该病毒造成的主要损害。然而，最近的数据强调了新冠病毒相关疾病（即 COVID-19）对肝脏的影响。在 COVID-19 期间，肝脏异常显著增加，患有先前存在的肝脏疾病的患者感染更为严重，其中最常见的是代谢相关脂肪性肝病（MAFLD）。据描述，MAFLD 患者患重症 COVID-19 的风险更高，肝酶异常和病毒脱落时间更长。MAFLD 患者的纤维化存在是 COVID-19 严重程度的另一个危险因素。由于 MAFLD 的患病率不断上升，可以推测很大一部分人群可能有患重症 COVID-19 的风险，通过使用肝酶作为风险预测因子来识别这些患者可能对早期诊断和感染管理至关重要。
