[Pathological anatomy of the liver in patients who died from COVID-19 in the acute period and in the late stages after the new coronavirus infection].

OBJECTIVE

A comparative analysis of morphological changes in the liver in patients who died from COVID-19 and non-communicable diseases after the new coronavirus infection.

MATERIAL AND

METHODS

Morphological changes in the liver were studied in 37 patients who died from COVID-19 without previous pathology or bacterial superinfection and 10 from cardiovascular diseases within 40 to 300 days after COVID-19. H&E, Van Gieson, V. Picro-Mallory were used, immunohistochemical (IHC) reactions with antibodies to S-protein of SARS-CoV-2 and receptors for angiotensin converting enzyme type 2 (ACE 2).

RESULTS

S-protein of SARS-CoV-2 expression is found in cholangiocytes, vascular endothelium and mononuclear cells of portal tract infiltrate, and single hepatocytes, ACE 2 - in cholangiocytes and hepatocytes. Liver changes are consistent with the morphology of hypoxic hepatitis in combination with COVID-associated microangio-, coagulo-, and cholangiopathy. In some patients, secondary sclerosing cholangitis and liver fibrosis are formed in the outcome of the disease.

CONCLUSION

The study results do not allow us to exclude the role of SARS-CoV-2 in the pathogenesis of liver damage in COVID-19. Specific features of hypoxic hepatitis in COVID-19 are microangio-, coagulo- and cholangiopathy. Many other factors, the effect of which was excluded as much as possible from the study (bacterial superinfection, hepatotoxic drugs etc.) also play a large role in the pathogenesis of its pathology in COVID-19.