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Hepatic involvement in COVID-19 patients: Pathology, pathogenesis, and clinical implications

Yueying Li1, Shu-Yuan Xiao1,2

  • 1Department of Pathology, Zhongnan Hospital of Wuhan University, Wuhan, China.

Journal of Medical Virology
|May 6, 2020
PubMed

Insights

Coronavirus disease 2019 (COVID-19) can cause liver injury, especially in severe cases. Pathologic changes include inflammation and necrosis, potentially due to the virus or medications.

Area of Science:

  • Hepatology
  • Virology
  • Pathology

Background:

  • Coronavirus disease 2019 (COVID-19) is associated with liver injury in a significant patient proportion.
  • Severe and critical illness cases show a higher incidence of hepatic complications.
  • Reported pathological changes include sinusoidal lymphocytic infiltration, dilatation, steatosis, and multifocal hepatic necrosis.

Purpose of the Study:

  • To investigate the mechanisms and pathological changes of liver injury in COVID-19 patients.
  • To explore the contributing factors to COVID-19-related hepatic injury.

Main Methods:

  • Analysis of pathological changes in liver tissues from COVID-19 patients.
  • Review of clinical data and potential etiological factors.

Main Results:

  • Observed mild sinusoidal lymphocytic infiltration, sinusoidal dilatation, steatosis, and multifocal hepatic necrosis.
  • Identified direct viral injury and drug-induced hepatotoxicity as likely mechanisms.
  • Noted exacerbation of chronic liver disease and hyperinflammatory reactions as contributing factors.

Conclusions:

  • COVID-19 can lead to significant hepatic injury through direct viral effects and drug toxicity.
  • Pre-existing liver conditions and systemic inflammation may worsen COVID-19-related liver damage.
  • Further autopsy studies are needed to fully elucidate the pathogenesis of COVID-19-associated liver injury.

Keywords:
COVID-19coronavirushepatotoxicityliver injurypathogenesis

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