Findings of Hepatic Severe Acute Respiratory Syndrome Coronavirus-2 InfectionSummary
Background & Aims: 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. Methods: T...
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doaj-70bc5941a3bc42b6973fb875c93d699d2021-02-23T04:09:24ZengElsevierCellular and Molecular Gastroenterology and Hepatology2352-345X2021-01-01113763770Findings of Hepatic Severe Acute Respiratory Syndrome Coronavirus-2 InfectionSummaryM. Isabel Fiel0Siraj M. El Jamal1Alberto Paniz-Mondolfi2Ronald E. Gordon3Jason Reidy4Jela Bandovic5Rashmi Advani6Saikiran Kilaru7Kamron Pourmand8Stephen Ward9Swan N. Thung10Thomas Schiano11Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, New York; Correspondence Address correspondence to: M. Isabel Fiel, MD, MS, Annenberg 15th Floor, Mount Sinai Hospital, New York, New York 10029. fax: (212) 828-4188.Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, New YorkDepartment of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, New YorkDepartment of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, New YorkDepartment of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, New YorkDepartment of Pathology and Division of Gastroenterology, State University of New York, Stony Brook Medical Center, Stony Brook, New YorkDepartment of Pathology and Division of Gastroenterology, State University of New York, Stony Brook Medical Center, Stony Brook, New YorkDivision of Liver Diseases and Recanati-Miller Transplant Institute, Icahn School of Medicine at Mount Sinai, New York, New YorkDivision of Liver Diseases and Recanati-Miller Transplant Institute, Icahn School of Medicine at Mount Sinai, New York, New YorkDepartment of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, New YorkDepartment of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, New YorkDivision of Liver Diseases and Recanati-Miller Transplant Institute, Icahn School of Medicine at Mount Sinai, New York, New YorkBackground & Aims: 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. Methods: 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. Results: 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. Conclusions: 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.http://www.sciencedirect.com/science/article/pii/S2352345X20301582COVID-19Non-hepatotropic VirusHepatitisLiver BiopsySARS-CoV-2Liver Injury |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
M. Isabel Fiel Siraj M. El Jamal Alberto Paniz-Mondolfi Ronald E. Gordon Jason Reidy Jela Bandovic Rashmi Advani Saikiran Kilaru Kamron Pourmand Stephen Ward Swan N. Thung Thomas Schiano |
spellingShingle |
M. Isabel Fiel Siraj M. El Jamal Alberto Paniz-Mondolfi Ronald E. Gordon Jason Reidy Jela Bandovic Rashmi Advani Saikiran Kilaru Kamron Pourmand Stephen Ward Swan N. Thung Thomas Schiano Findings of Hepatic Severe Acute Respiratory Syndrome Coronavirus-2 InfectionSummary Cellular and Molecular Gastroenterology and Hepatology COVID-19 Non-hepatotropic Virus Hepatitis Liver Biopsy SARS-CoV-2 Liver Injury |
author_facet |
M. Isabel Fiel Siraj M. El Jamal Alberto Paniz-Mondolfi Ronald E. Gordon Jason Reidy Jela Bandovic Rashmi Advani Saikiran Kilaru Kamron Pourmand Stephen Ward Swan N. Thung Thomas Schiano |
author_sort |
M. Isabel Fiel |
title |
Findings of Hepatic Severe Acute Respiratory Syndrome Coronavirus-2 InfectionSummary |
title_short |
Findings of Hepatic Severe Acute Respiratory Syndrome Coronavirus-2 InfectionSummary |
title_full |
Findings of Hepatic Severe Acute Respiratory Syndrome Coronavirus-2 InfectionSummary |
title_fullStr |
Findings of Hepatic Severe Acute Respiratory Syndrome Coronavirus-2 InfectionSummary |
title_full_unstemmed |
Findings of Hepatic Severe Acute Respiratory Syndrome Coronavirus-2 InfectionSummary |
title_sort |
findings of hepatic severe acute respiratory syndrome coronavirus-2 infectionsummary |
publisher |
Elsevier |
series |
Cellular and Molecular Gastroenterology and Hepatology |
issn |
2352-345X |
publishDate |
2021-01-01 |
description |
Background & Aims: 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. Methods: 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. Results: 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. Conclusions: 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. |
topic |
COVID-19 Non-hepatotropic Virus Hepatitis Liver Biopsy SARS-CoV-2 Liver Injury |
url |
http://www.sciencedirect.com/science/article/pii/S2352345X20301582 |
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