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Thrombotic sinusoiditis and local diffuse intrasinusoidal coagulation in the liver of subjects affected by COVID-19: the evidence from histology and scanning electron microscopy.
Fanni, D; Cerrone, G; Saba, L; Demontis, R; Congiu, T; Piras, M; Gerosa, C; Suri, J S; Coni, P; Caddori, A; Piga, M; Mancosu, G; Barcellona, D; Ravarino, A; Chighine, A; Cau, F; Scano, A; Balestrieri, A; Coghe, F; Orrù, G; Van Eyken, P; La Nasa, G; D'Aloia, E; Marongiu, F; Faa, G.
  • Fanni D; Division of Pathology, Department of Medical Sciences and Public Health, AOU of Cagliari, University of Cagliari, Cagliari, Italy. daniela.fanni@unica.it.
Eur Rev Med Pharmacol Sci ; 25(19): 5904-5912, 2021 10.
Article in English | MEDLINE | ID: covidwho-1478932
ABSTRACT

OBJECTIVE:

Liver injury has been reported in patients with COVID-19. This condition is characterized by severe outcome and could be related with the ability of SARS-CoV-2 to activate cytotoxic T cells. The purpose of this study is to show the histological and scanning electron microscopy features of liver involvement in COVID-19 to characterize the liver changes caused by the activation of multiple molecular pathways following this infection. PATIENTS AND

METHODS:

Liver biopsies from 4 patients (3 post-mortems and 1 in vivo) with COVID-19 were analyzed with histology and by scanning electron microscopy.

RESULTS:

The liver changes showed significant heterogeneity. The first case showed ground glass hepatocytes and scattered fibrin aggregates in the sinusoidal lumen. The second evidenced intra-sinusoidal thrombi. The third was characterized by sinusoidal dilatation, atrophy of hepatocytes, Disse's spaces dilatation and intra-sinusoidal aggregates of fibrin and red blood cells. The fourth case exhibited diffuse fibrin aggregates in the dilated Disse spaces and microthrombi in the sinusoidal lumen.

CONCLUSIONS:

In COVID-19-related liver injury, a large spectrum of pathological changes was observed. The most peculiar features were very mild inflammation, intra-sinusoidal changes, including sinusoidal dilatation, thrombotic sinusoiditis and diffuse intra-sinusoidal fibrin deposition. These findings suggested that a thrombotic sinusoiditis followed by a local diffuse intra-vascular (intra-sinusoidal) coagulation could be the typical features of the SARS-CoV-2-related liver injury.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Thrombosis / Blood Coagulation Disorders / COVID-19 / Liver / Liver Diseases Type of study: Evidence synthesis Limits: Adult / Aged / Humans / Male / Middle aged / Young adult Language: English Journal: Eur Rev Med Pharmacol Sci Journal subject: Pharmacology / Toxicology Year: 2021 Document Type: Article Affiliation country: Eurrev_202110_26866

Full text: Available Collection: International databases Database: MEDLINE Main subject: Thrombosis / Blood Coagulation Disorders / COVID-19 / Liver / Liver Diseases Type of study: Evidence synthesis Limits: Adult / Aged / Humans / Male / Middle aged / Young adult Language: English Journal: Eur Rev Med Pharmacol Sci Journal subject: Pharmacology / Toxicology Year: 2021 Document Type: Article Affiliation country: Eurrev_202110_26866