SARS-CoV-2 infection of the liver directly contributes to hepatic impairment in patients with COVID-19

• DOI: 10.1016/j.jhep.2020.05.002
• Publication Date: 2020-05-11T03:06:52Z
• Authors: Yijin Wang; Shuhong Liu; Hongyang Liu; Wei Li; Fang Lin; Lina Jiang; Xi Li; Pengfei Xu; Lixin Zhang; Lihua Zhao; Yun Cao; Jiarui Kang; Jianfa Yang; Ling Li; Xiaoyan Liu; Yan Li; Ruifang Nie; Jinsong Mu; Fengmin Lu; Shousong Zhao; Jiangyang Lu; Jingmin Zhao
• Keywords: Liver disease; Gamma-glutamyltransferase

•Liver enzyme abnormalities in patients with COVID-19 are associated disease severity.•Patients liver have higher A-aDO2 and GGT, lower albumin decreased circulating CD4+ T cells B lymphocytes.•SARS-CoV-2 is able to infect the cause conspicuous hepatic cytopathy.•Massive apoptosis binuclear hepatocytes were predominant histological features of SARS-CoV-2-infected liver. Background & AimsLiver common coronavirus 2019 (COVID-19). Whether or not severe acute respiratory syndrome 2 (SARS-CoV-2) infection can lead damage per se remains unknown. Herein, we reported clinical characteristics pathological manifestations abnormalities.MethodsWe analyzed 156 diagnosed from designated centers China compared between without elevated aminotransferases. Postmortem biopsies obtained cases who had We investigated patterns impairment by electron microscopy, immunohistochemistry, TUNEL assay studies.ResultsSixty-four out (41.0%) The median levels alanine aminotransferase 50 U/L vs. 19 U/L, respectively, aspartate 45.5 24 respectively abnormal normal groups. Liver severity, as well a series laboratory tests including alveolar-arterial oxygen partial pressure difference, gamma-glutamyltransferase, albumin, lymphocytes. Ultrastructural examination identified typical particles, characterized spike structures, cytoplasm cases. displayed mitochondrial swelling, endoplasmic reticulum dilatation glycogen granule decrease. Histologically, massive some observed. Taken together, both ultrastructural evidence indicated lesion viral infection. Immunohistochemical results showed scarce CD8+ No obvious eosinophil infiltration, cholestasis, fibrin deposition, granuloma, central necrosis, interface hepatitis observed.ConclusionsSARS-CoV-2 directly contributes COVID-19. Hence, surveillance clearance long-term outcome required.Lay summaryLiver enzymes. Our findings suggested that SARS-CoV-2 crucial factor contributing abnormalities. studies. Sixty-four required.