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The pandemic characteristics and high\u2010lethality rate of COVID\u201019 infection have raised concerns about interactions between virus pathobiology and components of the metabolic syndrome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We harmonized the information from the recent existing literature on COVID\u201019 acute pandemic and mechanisms of damage in non\u2010alcoholic fatty liver disease (NAFLD), as an example of chronic (non\u2010communicable) metabolic pandemic.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>COVID\u201019\u2010infected patients are more fragile with underlying metabolic illness, including hypertension, cardiovascular disease, type 2 diabetes, chronic lung diseases (e.g. asthma, chronic obstructive pulmonary disease and emphysema) and metabolic syndrome. During metabolic abnormalities, expansion of metabolically active fat ('overfat condition') parallels chronic inflammatory changes, development of insulin resistance and accumulation of fat in configuring NAFLD. The deleterious interplay of inflammatory pathways chronically active in NAFLD and acutely in COVID\u201019\u2010infected patients, can explain liver damage in a subgroup of patients and might condition a worse outcome in metabolically compromised NAFLD patients. In a subgroup of patients with NAFLD, the underlying liver fibrosis might represent an additional and independent risk factor for severe COVID\u201019 illness, irrespective of metabolic comorbidities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>NAFLD can play a role in the outcome of COVID\u201019 illness due to frequent association with comorbidities. Initial evidences suggest that increased liver fibrosis in NAFLD might affect COVID\u201019 outcome. In addition, long\u2010term monitoring of post\u2010COVID\u201019 NAFLD patients is advisable, to document further deterioration of liver damage. Further studies are required in this field.<\/jats:p><\/jats:sec>","DOI":"10.1111\/eci.13338","type":"journal-article","created":{"date-parts":[[2020,6,27]],"date-time":"2020-06-27T09:16:09Z","timestamp":1593249369000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":118,"title":["COVID\u201019 and non\u2010alcoholic fatty liver disease: Two intersecting pandemics"],"prefix":"10.1111","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5359-1471","authenticated-orcid":false,"given":"Piero","family":"Portincasa","sequence":"first","affiliation":[{"name":"Clinica Medica \u2018A. 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