摘要
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.
