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Published on: February 10, 2015
COVID-19-Related Cholangiopathy: Histological Findings.
Valéria F A Borges1, Helma P Cotrim2, Antônio Ricardo C F Andrade2
1Postgraduate Program in Medicine and Health, Federal University of Bahia, Salvador 40026-010, Brazil.
Liver biopsies from severe COVID-19 survivors with cholestasis show histopathological changes similar to secondary sclerosing cholangitis in critically ill patients (SSC-CIP). Notable findings include endothelial cell swelling and small vessel thrombosis.
Area of Science:
- Hepatology
- Virology
- Critical Care Medicine
Background:
- Cholangiopathy is a recognized complication in severe COVID-19 survivors.
- This condition shares clinical similarities with secondary sclerosing cholangitis in critically ill patients (SSC-CIP).
Purpose of the Study:
- To investigate the liver histopathology in patients experiencing persistent cholestasis after severe COVID-19.
- To compare these findings with known changes in SSC-CIP.
Main Methods:
- Liver biopsies from ten post-COVID-19 cholestasis patients were analyzed using routine staining and cytokeratin 7 immunostaining.
- Portal and parenchymal changes were semi-quantitatively assessed.
Main Results:
- All patients exhibited portal/periportal fibrosis, ductular proliferation, and bile duct dystrophy.
- Hepatocyte biliary metaplasia was universal; cholestasis and bile plugs were common.
- Endothelial cell swelling, vessel wall necrosis, and thrombosis were observed, distinguishing features.
Conclusions:
- Liver histopathology in severe COVID-19 survivors with cholestasis resembles SSC-CIP.
- Specific vascular and endothelial changes were more pronounced in the COVID-19 cohort.
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