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World J Gastroenterol . COVID-19 and pediatric fatty liver disease: Is there interplay?

tetano

Editor, Senior Moderator
World J Gastroenterol


. 2021 Jun 14;27(22):3064-3072.
doi: 10.3748/wjg.v27.i22.3064.
COVID-19 and pediatric fatty liver disease: Is there interplay?


Anna Di Sessa[SUP] 1 [/SUP], Francesca Lanzaro[SUP] 2 [/SUP], Sarah Zarrilli[SUP] 2 [/SUP], Vittorio Picone[SUP] 2 [/SUP], Stefano Guarino[SUP] 2 [/SUP], Emanuele Miraglia Del Giudice[SUP] 2 [/SUP], Pierluigi Marzuillo[SUP] 2 [/SUP]



Affiliations

Abstract

The rapid global spread of coronavirus disease 2019 (COVID-19) infection has become a major health issue with higher morbidity and mortality rates. Besides respiratory symptoms, a growing body of evidence indicates a variety of gastrointestinal manifestations including liver involvement. In this regard, several data supported an association between COVID-19 infection and liver injury in adults, while in children there is compelling but currently limited evidence. In particular, patients with COVID-19 have shown a higher risk of liver injury (mainly expressed as increased transaminase levels or hepatic steatosis). Conversely, a greater risk of more severe forms of COVID-19 infection has been observed in subjects with pre-existing chronic liver diseases. The dramatic interplay between COVID-19 and liver damage has been related to the inflammatory pathways chronically active in patients with nonalcoholic fatty liver disease and acutely in those affected by COVID-19, but other different pathogenic mechanisms have also been supposed. Of note, patients with previous metabolic comorbidities also had a higher risk of severe COVID-19 infection. This emphasizes the pathogenic interrelation of the inflammatory pathways with a dysregulated metabolic milieu in COVID-19 patients. Taking into account the prognostic role of fatty liver in COVID-19 patients and its intrinsic relationship with metabolic abnormalities even in childhood, a strict monitoring of this condition is recommended. We aimed to summarize the most recent evidence regarding the potential interplay between pediatric fatty liver and COVID-19.

Keywords: Adults; COVID-19; Children; Nonalcoholic fatty liver disease.
 
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