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Cellular and Molecular Gastroenterology and Hepatology
Article . 2021 . Peer-reviewed
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Other literature type . 2020
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Findings of Hepatic Severe Acute Respiratory Syndrome Coronavirus-2 Infection

Authors: Fiel, M. Isabel; El Jamal, Siraj M.; Paniz-Mondolfi, Alberto; Gordon, Ronald E.; Reidy, Jason; Bandovic, Jela; Advani, Rashmi; +5 Authors

Findings of Hepatic Severe Acute Respiratory Syndrome Coronavirus-2 Infection

Abstract

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.

Keywords

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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    This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
    Top 1%
    influence
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    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
    Top 1%
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citations
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
47
Top 1%
Top 10%
Top 1%
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gold