MAFLD, severe COVID-19 and the gut-liver axis

Commentary

As pointed out by Gabriella Assante et al. (The Institute of Hepatology, Foundation for Liver Research, London, UK), two recent studies in the Journal of Hepatology suggest that MAFLD is a risk factor for progression to severe COVID-19. More studies are required to confirm this. However, it potentially adds MAFLD to a list of risk factors that also includes obesity, type 2 diabetes, chronic lung disease, inflammatory bowel disease, asthma, cardiovascular disease, immunodeficiency, and renal failure.

MAFLD, obesity and T2D are major contributors to the overall number of patients with COVID-19 that require hospitalization. Therapeutics that have been developed for IBD could reduce the number of patients with MAFLD/obesity/T2D that progress to severe COVID-19, and caution may have to be taken with drugs that disturb intestinal microbiota composition or abundance.