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Liver and gallbladder diseases are a significant health concern, with prominent conditions including cirrhosis, hepatitis, non-alcoholic fatty liver disease (NAFLD), and gallstones. Jaundice is a common manifestation of liver and biliary disease.
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The microscopic anatomy of the liver is a complex and intricate system that comprises numerous structural units known as liver lobules, each of which is comparable in size to a sesame seed. These hexagonal structures consist of plates of liver cells or hepatocytes, which are characterized by their versatility and abundance of cellular apparatus like rough and smooth ER, Golgi apparatus, peroxisomes, and mitochondria.
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The hepatic portal system, a critical part of our circulatory framework, transports nutrient-laden, deoxygenated blood from the gastrointestinal tract and spleen to the liver. This ingenious system plays an indispensable role in maintaining our body's metabolic equilibrium.
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[Liver pathology in COVID-19].

S F Krasnenkova1,2, O V Zayratyants1,3, K Yu Midiber3,4

  • 1Russian University of Medicine, Moscow, Russia.

Arkhiv Patologii
|February 13, 2025
PubMed
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COVID-19 commonly causes liver damage, including steatosis and failure, especially in those with chronic liver disease. The exact cause remains unclear, likely involving multiple factors beyond direct viral attack.

Keywords:
COVID-19liver pathologypathogenesispathological anatomy

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Area of Science:

  • Hepatology
  • Virology
  • Pathology

Background:

  • Liver damage is frequently observed in patients with COVID-19.
  • This damage includes steatosis, vascular issues, inflammation, cholestasis, and potentially liver failure.
  • Pre-existing chronic liver diseases are exacerbated by SARS-CoV-2 infection, worsening patient prognosis.

Purpose of the Study:

  • To review and analyze the pathogenesis and pathological anatomy of liver damage in COVID-19.
  • To explore the potential mechanisms contributing to liver injury in SARS-CoV-2 infected individuals.

Main Methods:

  • Literature review and analysis of existing studies on COVID-19 and liver pathology.
  • Examination of reported pathological and anatomical changes in the liver of COVID-19 patients.

Main Results:

  • The majority of COVID-19 patients exhibit liver damage, characterized by steatosis, vascular disorders, mild inflammatory infiltration, cholestasis, and liver failure.
  • SARS-CoV-2 infection can lead to decompensation of chronic liver diseases, negatively impacting disease outcomes.
  • Direct SARS-CoV-2 cytotoxicity to hepatocytes or cholangiocytes lacks convincing evidence.
  • Observed liver changes are likely multifactorial, stemming from hypoxia, cytokine storm, systemic inflammatory response syndrome, sepsis, shock, coagulopathy, and drug-induced hepatotoxicity.

Conclusions:

  • The pathogenesis of liver damage in COVID-19 is complex and multifactorial.
  • Hypoxia, systemic inflammation, coagulopathy, and drug toxicity are implicated in COVID-19-related liver injury.
  • Further research is essential to fully elucidate the pathogenesis and pathological anatomy of liver pathology in COVID-19.