Fig. 1.

Possible interconnections between COVID-19 and MAFLD. Disturbed liver laboratory parameters are frequently observed in severe COVID-19 cases. Patients infected by SARS-CoV-2 often exhibit also liver steatosis, while MAFLD seems to aggravate COVID-19. SARS-CoV-2 could induce PAMP translocation from the gut to the liver to initiate Kupffer cell and stellate cell activation and hence promote an acute inflammatory response. Further, the liver could get damaged or primed for secondary hits by cytokines during cytokine storms. Until today, cholangiocytes are the only liver cells known to express the virus entry receptor ACE2, although specific consequences remain to be investigated