Department of Endocrinology and Metabolism, University Hospitals of Edinburgh, Edinburgh EH4 2XU, United Kingdom.
Department of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University, Richmond, VA 23298, United States.
World J Gastroenterol. 2023 Jan 21;29(3):487-502. doi: 10.3748/wjg.v29.i3.487.
People across the world are affected by the "coronavirus disease 2019 (COVID-19)", brought on by the "SARS-CoV type-2 coronavirus". Due to its high incidence in individuals with diabetes, metabolic syndrome, and metabolic-associated fatty liver disease (MAFLD), COVID-19 has gained much attention. The metabolic syndrome's hepatic manifestation, MAFLD, carries a significant risk of type-2-diabetes. The link between the above two conditions has also drawn increasing consideration since MAFLD is intricately linked to the obesity epidemic. Independent of the metabolic syndrome, MAFLD may impact the severity of the viral infections, including COVID-19 or may even be a risk factor. An important question is whether the present COVID-19 pandemic has been fueled by the obesity and MAFLD epidemics. Many liver markers are seen elevated in COVID-19. MAFLD patients with associated comorbid conditions like obesity, cardiovascular disease, renal disease, malignancy, hypertension, and old age are prone to develop severe disease. There is an urgent need for more studies to determine the link between the two conditions and whether it might account for racial differences in the mortality and morbidity rates linked to COVID-19. The role of innate and adaptive immunity alterations in MAFLD patients may influence the severity of COVID-19. This review investigates the implications of COVID-19 on liver injury and disease severity and vice-versa. We also addressed the severity of COVID-19 in patients with prior MAFLD and its potential implications and therapeutic administration in the clinical setting.
全球范围内的人们都受到了“2019 年冠状病毒病(COVID-19)”的影响,这种疾病是由“严重急性呼吸综合征冠状病毒 2 型(SARS-CoV-2)”引起的。由于 COVID-19 在糖尿病、代谢综合征和代谢相关脂肪性肝病(MAFLD)患者中的发病率较高,因此引起了广泛关注。代谢综合征的肝脏表现形式 MAFLD,使 2 型糖尿病的发病风险显著增加。由于 MAFLD 与肥胖症的流行密切相关,因此这两种疾病之间的联系也引起了越来越多的关注。除了代谢综合征之外,MAFLD 可能会影响包括 COVID-19 在内的病毒感染的严重程度,甚至可能成为一个危险因素。一个重要的问题是,目前的 COVID-19 大流行是否是由肥胖症和 MAFLD 流行所推动的。在 COVID-19 中,许多肝脏标志物的水平升高。患有肥胖症等相关合并症的 MAFLD 患者,如心血管疾病、肾脏疾病、恶性肿瘤、高血压和老年患者,更容易发生严重疾病。迫切需要更多的研究来确定这两种疾病之间的联系,以及它们是否可能导致与 COVID-19 相关的死亡率和发病率的种族差异。MAFLD 患者固有和适应性免疫改变的作用可能会影响 COVID-19 的严重程度。本综述探讨了 COVID-19 对肝脏损伤和疾病严重程度的影响,反之亦然。我们还探讨了 MAFLD 患者先前 COVID-19 的严重程度及其在临床环境中的潜在意义和治疗管理。