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Liver injury due to coronavirus disease 2019 (COVID-19) is being increasingly recognized. Abnormal liver chemistry tests of varying severities occur in a majority of patients. However, there is a dearth of accompanying liver histologic studies in these patients.The current report details the clinical courses of 2 patients having severe COVID-19 hepatitis. Liver biopsies were analyzed under light microscopy, portions of liver tissue were hybridized with a target probe to the severe acute respiratory syndrome coronavirus-2 S gene, and small sections from formalin-fixed paraffin-embedded liver tissue were processed for electron microscopy.The liver histology of both cases showed a mixed inflammatory infiltrate with prominent bile duct damage, endotheliitis, and many apoptotic bodies. In situ hybridization and electron microscopy suggest the intrahepatic presence of severe acute respiratory syndrome coronavirus-2, the findings of which may indicate the possibility of direct cell injury.On the basis of the abundant apoptosis and severe cholangiocyte injury, these histopathologic changes suggest a direct cytopathic injury. Furthermore, some of the histopathologic changes may resemble acute cellular rejection occurring after liver transplantation. These 2 cases demonstrate that severe COVID-19 hepatitis can occur even in the absence of significant involvement of other organs.
Adult, Male, Hepatology, SARS-CoV-2, Biopsy, Liver Diseases, Gastroenterology, COVID-19, Apoptosis, RC799-869, Diseases of the digestive system. Gastroenterology, Middle Aged, Liver Injury, Liver Biopsy, Hepatitis, Liver, Non-hepatotropic Virus, Humans, Female, Original Research
Adult, Male, Hepatology, SARS-CoV-2, Biopsy, Liver Diseases, Gastroenterology, COVID-19, Apoptosis, RC799-869, Diseases of the digestive system. Gastroenterology, Middle Aged, Liver Injury, Liver Biopsy, Hepatitis, Liver, Non-hepatotropic Virus, Humans, Female, Original Research
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influence This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically). | Top 10% | |
impulse This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network. | Top 1% |