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...

Full description

Bibliographic Details
Main Authors: 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
Format: Article
Language:English
Published: Elsevier 2021-01-01
Series:Cellular and Molecular Gastroenterology and Hepatology
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2352345X20301582
id doaj-70bc5941a3bc42b6973fb875c93d699d
record_format Article
spelling 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
work_keys_str_mv AT misabelfiel findingsofhepaticsevereacuterespiratorysyndromecoronavirus2infectionsummary
AT sirajmeljamal findingsofhepaticsevereacuterespiratorysyndromecoronavirus2infectionsummary
AT albertopanizmondolfi findingsofhepaticsevereacuterespiratorysyndromecoronavirus2infectionsummary
AT ronaldegordon findingsofhepaticsevereacuterespiratorysyndromecoronavirus2infectionsummary
AT jasonreidy findingsofhepaticsevereacuterespiratorysyndromecoronavirus2infectionsummary
AT jelabandovic findingsofhepaticsevereacuterespiratorysyndromecoronavirus2infectionsummary
AT rashmiadvani findingsofhepaticsevereacuterespiratorysyndromecoronavirus2infectionsummary
AT saikirankilaru findingsofhepaticsevereacuterespiratorysyndromecoronavirus2infectionsummary
AT kamronpourmand findingsofhepaticsevereacuterespiratorysyndromecoronavirus2infectionsummary
AT stephenward findingsofhepaticsevereacuterespiratorysyndromecoronavirus2infectionsummary
AT swannthung findingsofhepaticsevereacuterespiratorysyndromecoronavirus2infectionsummary
AT thomasschiano findingsofhepaticsevereacuterespiratorysyndromecoronavirus2infectionsummary
_version_ 1724255261980360704