ArticleModern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc2020
Hepatic pathology in patients dying of COVID-19: a series of 40 cases including clinical, histologic, and virologic data.
Article in Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 147 papers.
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147 citing papers in PubMed, 236 citations in OpenAlex.
- Exacerbated Hepatic Stress and Systemic Metabolic Disruption Driven by SARS-CoV-2 P.1 Variant in K18-hACE2 Mice.Immunity, inflammation and disease · 2026Article
- Histological features of liver biopsy in patients with COVID-19: a single institution experience with long term follow-up outcome.Diagnostic pathology · 2026Article
- Case Report: Recurrent intrahepatic cholestasis: two rare cases with their novel variants of ATB8B1 and atypical clinical findings.Frontiers in medicine · 2026Article
- The neurobiological regulatory mechanism of brain edema.Frontiers in cellular neuroscience · 2026Review
- Integrative transcriptomic and single-cell analysis reveals a convergent cholangiocyte-associated host inflammatory program in biliary atresia and SARS-CoV-2-associated hepatobiliary injury.Frontiers in immunology · 2026Article
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- COVID-19 Infection, Drugs, and Liver Injury.Journal of clinical medicine · 2025Review
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- Computed Tomography Radiomics and Machine Learning for Prediction of Histology-Based Hepatic Steatosis Scores.Diagnostics (Basel, Switzerland) · 2025Article
- Obliteration of liver sinusoids through platelet aggregates associated to extramedullary haematopoiesis in myeloid neoplasms.Virchows Archiv : an international journal of pathology · 2025Article
- COVID-19-associated secondary sclerosing cholangitis with liver transplantation.Virchows Archiv : an international journal of pathology · 2024Article
- Histopathological impact of SARS-CoV-2 on the liver: Cellular damage and long-term complications.World journal of gastroenterology · 2024Review
- Molecular mechanisms underlying SARS-CoV-2 hepatotropism and liver damage.World journal of hepatology · 2024Article
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- Exploring the Role of Ki67 in the Liver of Diabetic Rats.Materia socio-medica · 2024Article
- Insight into COVID-19 associated liver injury: Mechanisms, evaluation, and clinical implications.Hepatology forum · 2024Review
- SARS-CoV-2 receptor ACE2 is upregulated by fatty acids in human MASH.JHEP reports : innovation in hepatology · 2024Article
- New insights into the pathogenesis of SARS-CoV-2 during and after the COVID-19 pandemic.Frontiers in immunology · 2024Review
- Organoids to Remodel SARS-CoV-2 Research: Updates, Limitations and Perspectives.Aging and disease · 2023Review
- Review
87 more citing papers are in PubMed but not listed here.
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Authors and funding
16 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The novel coronavirus SARS-CoV-2 (coronavirus disease 19, or COVID-19) primarily causes pulmonary injury, but has been implicated to cause hepatic injury, both by serum markers and histologic evaluation. The histologic pattern of injury has not been completely described. Studies quantifying viral load in the liver are lacking. Here we report the clinical and histologic findings related to the liver in 40 patients who died of complications of COVID-19. A subset of liver tissue blocks were subjected to polymerase chain reaction (PCR) for viral ribonucleic acid (RNA). Peak levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were elevated; median ALT peak 68 U/l (normal up to 46 U/l) and median AST peak 102 U/l (normal up to 37 U/l). Macrovesicular steatosis was the most common finding, involving 30 patients (75%). Mild lobular necroinflammation and portal inflammation were present in 20 cases each (50%). Vascular pathology, including sinusoidal microthrombi, was infrequent, seen in six cases (15%). PCR of liver tissue was positive in 11 of 20 patients tested (55%). In conclusion, we found patients dying of COVID-19 had biochemical evidence of hepatitis (of variable severity) and demonstrated histologic findings of macrovesicular steatosis and mild acute hepatitis (lobular necroinflammation) and mild portal inflammation. We also identified viral RNA in a sizeable subset of liver tissue samples.
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