key: cord-1014634-r62d1duf
authors: Gonzáles Yovera, Jhean Gabriel; Concepción‐Zavaleta, Marcio Jose; Coronado Arroyo, Julia; Moreno Marreros, Diego
title: Confluence of obesity and MAFLD during Covid‐19 pandemic in a developing country
date: 2020-10-21
journal: Endocrinol Diabetes Metab
DOI: 10.1002/edm2.189
sha: 3c3149727990be3f786f5b4ca87a2c7dc219639f
doc_id: 1014634
cord_uid: r62d1duf

The direct relation between the overweight/obesity, MAFLD and the severity SARS‐CoV‐2 infection. increase number of cases of obesity and MAFLD is an important risk factor for high mortality of COVID‐19 patients[Image: see text]

The article published by Seidu et al 1 has been of great interest to us, in which they found that high body mass index (BMI) is a risk factor for severe disease and mortality in patients with COVID-19, particularly pronounced in people 60 and older, and in people with BMI > 35 Kg/m 2 . This is something that is happening in Peru, in which preliminary findings reported by the Ministry of Health showed that among people who died from COVID-19, 85.5% had obesity as assessed by BMI.

Overweight and obesity continues to be a major public health problem in Peru. It varies with sex and geographic regions. It is known that obesity is more prevalent in Peruvian women (26%) than Peruvian men (19.3%). Currently, 22.7% of Peruvian population have obesity, and the individuals with weight excess, including overweight and obesity, reached 60%. 2 These two conditions are strongly related to prediabetes and diabetes, which exhibit a prevalence of 22.4% and 7%, respectively, in the Peruvian population. 3 All the risk factors mentioned above are part of an entity that is currently termed metabolic associated fatty liver disease (MAFLD), and the proposed criteria are based on histological, imaging or blood biomarker which evidence of fat accumulation in the liver in addition to one of the following three criteria: overweight/obesity, presence of type 2 diabetes mellitus (T2DM) or evidence of metabolic dysregulation. 4 The worldwide prevalence of MAFLD is estimated to be 24% 5 ; however, this prevalence may be underestimated because Currently, national programmes have been implemented in Peru focused only on reducing malnutrition, which can broaden their scope and objectives to consider these increasingly prevalent health problems, with primary educational preventive strategies and timely diagnosis in vulnerable populations. 7 In conclusion, because of the high prevalence of overweight and obesity, the implementation of effective health strategies focused in health promotion and primary prevention in developing countries is important to help decrease the rates of these diseases and establish a diagnostic protocol for MAFLD, as preliminary studies have highlighted the association between this pathology and its risk factors and the mortality and severity of SARS-CoV-2 infection.

The authors declare no conflict of interest. 

The impact of obesity on severe disease and mortality in people with SARS-CoV-2: A systematic review and meta-analysis

Prediabetes in Peru: consensus of experts

Prevalence of diabetes and impaired fasting glucose in Peru: report from PERUDIAB, a national urban population-based longitudinal study

A new definition for metabolic dysfunction-associated fatty liver disease: An international expert consensus statement

Metabolic dysfunction associated fatty liver disease increases risk of severe Covid-19

COVID-19: Abnormal liver function tests

Social programs and reducing obesity in Peru: reflections from the research