ArticleLiver international : official journal of the International Association for the Study of the Liver2020
Liver histopathology in severe COVID 19 respiratory failure is suggestive of vascular alterations.
Article in Liver international : official journal of the International Association for the Study of the Liver, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 172 papers, 5 of them syntheses that pooled it.
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Who cites it
172 citing papers in PubMed, 5 syntheses or guidelines pooled it, 270 citations in OpenAlex.
- Findings and inferences from full autopsies, minimally invasive autopsies and biopsy studies in patients who died as a result of COVID19 - A systematic review.Forensic science, medicine, and pathology · 2022Pooled it
- Autopsy Tool in Unknown Diseases: The Experience with Coronaviruses (SARS-CoV, MERS-CoV, SARS-CoV-2).Medicina (Kaunas, Lithuania) · 2021Pooled it
- Portal Vein Thrombosis Might Develop by COVID-19 Infection or Vaccination: A Systematic Review of Case-Report Studies.Frontiers in medicine · 2021Pooled it
- High prevalence of hepatic steatosis and vascular thrombosis in COVID-19: A systematic review and meta-analysis of autopsy data.World journal of gastroenterology · 2020Pooled it
- Pre-existing Liver Diseases and On-Admission Liver-Related Laboratory Tests in COVID-19: A Prognostic Accuracy Meta-Analysis With Systematic Review.Frontiers in medicine · 2020Pooled it
- COVID-19, the disease that changed the world.Medicine and pharmacy reports · 2026Review
- Diagnostic and immunological roles of leptin gene rs7799039 polymorphism and cytokines in COVID-19, HCV, and dual infection.Scientific reports · 2026Article
- Liver-Related COVID-19 Consequences: Dynamics of Liver Health in 2.5 Years.Journal of clinical medicine · 2025Article
- COVID-19 Infection, Drugs, and Liver Injury.Journal of clinical medicine · 2025Review
- Update in the treatment of cirrhotic patients with portal vein thrombosis.Clinical and molecular hepatology · 2025Review
- Assessing the consistency of FIB-4, APRI, and GPR in evaluating significant liver fibrosis and cirrhosis in COVID-19 patients with concurrent liver diseases.BMC gastroenterology · 2025Article
- A single-nucleus and spatial transcriptomic atlas of the COVID-19 liver reveals topological, functional, and regenerative organ disruption in patients.Genome biology · 2025Article
- FIB-4 Index Can Predict Mortality in Hospitalized Patients with COVID-19 Infection, Independent of CT Severity Score.Archives of Iranian medicine · 2025Article
- Current perspectives and trends of neutrophil extracellular traps in organ fibrosis: a bibliometric and visualization study.Frontiers in immunology · 2025Review
- SARS-CoV-2 Productively Infects Human Hepatocytes and Induces Cell Death.Journal of medical virology · 2025Article
- Combination of spatial transcriptomics analysis and retrospective study reveals liver infection of SARS-COV-2 is associated with clinical outcomes of COVID-19.EBioMedicine · 2025Article
- Portal Vein Thrombosis in COVID-19: An Underdiagnosed Disease?Journal of clinical medicine · 2024Article
- COVID-19-associated secondary sclerosing cholangitis with liver transplantation.Virchows Archiv : an international journal of pathology · 2024Article
- Immune Response and Risk of Decompensation following SARS-CoV-2 Infection in Outpatients with Advanced Chronic Liver Disease.International journal of molecular sciences · 2024Observational
- Histopathological impact of SARS-CoV-2 on the liver: Cellular damage and long-term complications.World journal of gastroenterology · 2024Review
112 more citing papers are in PubMed but not listed here.
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Authors and funding
13 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
SARS2-CoV-2 breakout in Italy caused a huge number of severely ill patients with a serious increase in mortality. Although lungs seem to be the main target of the infection, very few information are available about liver involvement, possibly evocating a systemic disease. Post-mortem wedge liver biopsies from 48 patients died from severe pulmonary COVID-19 disease with respiratory failure were collected from two main hospitals in northern Italy. No patient had clinical symptoms of liver disease or signs of liver failure before and during hospitalization; for each of them liver function tests were available. All liver samples showed minimal inflammation features. Histological pictures compatible with vascular alterations were observed, characterized by increase in number of portal vein branches associated with lumen massive dilatation, partial or complete luminal thrombosis of portal and sinusoidal vessels, fibrosis of portal tract, focally markedly enlarged and fibrotic. SARS-CoV-2 was found in 15 of 22 samples tested by in situ hybridization method. Our preliminary results confirm the clinical impression that liver failure is not a main concern and this organ is not the target of significant inflammatory damage. Histopathological findings are highly suggestive for marked derangement of intrahepatic blood vessel network secondary to systemic changes induced by virus that could target not only lung parenchyma but also cardiovascular system, coagulation cascade and endothelial layer of blood vessels. It still remains unclear if the mentioned changes are directly related to virus infection or if SARS-CoV-2 triggers a series of reactions leading to striking vascular alterations.
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