{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T10:28:25Z","timestamp":1769077705107,"version":"3.49.0"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2021,4,29]],"date-time":"2021-04-29T00:00:00Z","timestamp":1619654400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Northwestern University Department of Pathology Resident Research Committee"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,5,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>The novel coronavirus, severe acute respiratory syndrome coronavirus 2, causing coronavirus disease 2019 (COVID-19) remains a global health threat and a significant source of human morbidity and mortality. While the virus primarily induces lung injury, it also has been reported to cause hepatic sequelae.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We aimed to detect the virus in formalin-fixed tissue blocks and document the liver injury patterns in patients with COVID-19 compared with a control group.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We were able to detect viral RNA in the bronchioalveolar cell blocks (12\/12, 100%) and formalin-fixed, paraffin-embedded tissue of the lung (8\/8, 100%) and liver (4\/9, 44%) of patients with COVID-19. Although the peak values of the main liver enzymes and bilirubin were higher in the patients with COVID-19 compared with the control group, the differences were not significant. The main histologic findings were minimal to focal mild portal tract chronic inflammation (7\/8, 88%, P &amp;lt; .05) and mild focal lobular activity (6\/8, 75%, P = .06).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>We found that most patients who died of COVID-19 had evidence of mild focal hepatitis clinically and histologically; however, the virus was detected in less than half of the cases.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ajcp\/aqab009","type":"journal-article","created":{"date-parts":[[2021,1,21]],"date-time":"2021-01-21T20:14:52Z","timestamp":1611260092000},"page":"802-814","source":"Crossref","is-referenced-by-count":42,"title":["Liver Pathology and SARS-CoV-2 Detection in Formalin-Fixed Tissue of Patients With COVID-19"],"prefix":"10.1093","volume":"155","author":[{"given":"Yevgen","family":"Chornenkyy","sequence":"first","affiliation":[{"name":"Departments of Pathology , Chicago, IL , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa","family":"Mejia-Bautista","sequence":"additional","affiliation":[{"name":"Departments of Pathology , Chicago, IL , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melanie","family":"Brucal","sequence":"additional","affiliation":[{"name":"Departments of Pathology , Chicago, IL , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy","family":"Blanke","sequence":"additional","affiliation":[{"name":"Departments of Pathology , Chicago, IL , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Dittmann","sequence":"additional","affiliation":[{"name":"Departments of Pathology , Chicago, IL , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anjana","family":"Yeldandi","sequence":"additional","affiliation":[{"name":"Departments of Pathology , Chicago, IL , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9364-8807","authenticated-orcid":false,"given":"Justin R","family":"Boike","sequence":"additional","affiliation":[{"name":"Gastroenterology and Hepatology , Chicago, IL , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0438-2427","authenticated-orcid":false,"given":"Jon W","family":"Lomasney","sequence":"additional","affiliation":[{"name":"Departments of Pathology , Chicago, IL , USA"},{"name":"Pharmacology, Northwestern University, Feinberg School of Medicine , Chicago, IL , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ritu","family":"Nayar","sequence":"additional","affiliation":[{"name":"Departments of Pathology , Chicago, IL , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lawrence J","family":"Jennings","sequence":"additional","affiliation":[{"name":"Departments of Pathology , Chicago, IL , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maryam Kherad","family":"Pezhouh","sequence":"additional","affiliation":[{"name":"Departments of Pathology , Chicago, IL , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,4,29]]},"reference":[{"key":"2023021216111439100_CIT0001","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1056\/NEJMoa2001017","article-title":"A novel coronavirus from patients with pneumonia in China, 2019","volume":"382","author":"Zhu","year":"2020","journal-title":"N Engl J Med."},{"key":"2023021216111439100_CIT0002","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1038\/s41575-020-0328-2","article-title":"COVID-19 and the liver-related deaths to come","volume":"17","author":"Pawlotsky","year":"2020","journal-title":"Nat Rev Gastroenterol Hepatol."},{"key":"2023021216111439100_CIT0003","year":"2020"},{"key":"2023021216111439100_CIT0004","doi-asserted-by":"crossref","first-page":"1864","DOI":"10.1126\/science.1116480","article-title":"Structure of SARS coronavirus spike receptor-binding domain complexed with receptor","volume":"309","author":"Li","year":"2005","journal-title":"Science."},{"key":"2023021216111439100_CIT0005","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1007\/s00134-020-05985-9","article-title":"Angiotensin-converting enzyme 2 (ACE2) as a SARS-CoV-2 receptor: molecular mechanisms and potential therapeutic target","volume":"46","author":"Zhang","year":"2020","journal-title":"Intensive Care Med."},{"key":"2023021216111439100_CIT0006","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1016\/j.cell.2020.02.052","article-title":"SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor","volume":"181","author":"Hoffmann","year":"2020","journal-title":"Cell."},{"key":"2023021216111439100_CIT0007","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1002\/path.1570","article-title":"Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus: a first step in understanding SARS pathogenesis","volume":"203","author":"Hamming","year":"2004","journal-title":"J Pathol."},{"key":"2023021216111439100_CIT0008","author":"The Human Protein Atlas","year":"2020"},{"key":"2023021216111439100_CIT0009","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/j.bbrc.2020.03.044","article-title":"Single cell RNA sequencing of 13 human tissues identify cell types and receptors of human coronaviruses","volume":"526","author":"Qi","year":"2020","journal-title":"Biochem Biophys Res Commun."},{"key":"2023021216111439100_CIT0010","article-title":"Specific ACE2 expression in cholangiocytes may cause liver damage after 2019-nCoV infection","author":"Chai","year":"2020","journal-title":"bioRxiv."},{"key":"2023021216111439100_CIT0011","doi-asserted-by":"crossref","first-page":"1790","DOI":"10.1136\/gut.2004.062398","article-title":"Chronic liver injury in rats and humans upregulates the novel enzyme angiotensin converting enzyme 2","volume":"54","author":"Paizis","year":"2005","journal-title":"Gut."},{"key":"2023021216111439100_CIT0012","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1016\/j.humpath.2020.07.023","article-title":"A review of the main histopathological findings in coronavirus disease 2019","volume":"105","author":"Vasquez-Bonilla","year":"2020","journal-title":"Hum Pathol."},{"key":"2023021216111439100_CIT0013","article-title":"Pathological study of the 2019 novel coronavirus disease (COVID-19) through postmortem core biopsies [published online April 14, 2020]","author":"Tian","journal-title":"Mod Pathol."},{"key":"2023021216111439100_CIT0014","first-page":"411","article-title":"A pathological report of three COVID-19 cases by minimal invasive autopsies","volume":"49","author":"Yao","year":"2020","journal-title":"Zhonghua Bing Li Xue Za Zhi."},{"key":"2023021216111439100_CIT0015","doi-asserted-by":"crossref","first-page":"2110","DOI":"10.1111\/liv.14601","article-title":"Liver histopathology in severe COVID 19 respiratory failure is suggestive of vascular alterations","volume":"40","author":"Sonzogni","year":"2020","journal-title":"Liver Int."},{"key":"2023021216111439100_CIT0016","doi-asserted-by":"crossref","first-page":"2147","DOI":"10.1038\/s41379-020-00649-x","article-title":"Hepatic pathology in patients dying of COVID-19: a series of 40 cases including clinical, histologic, and virologic data","volume":"33","author":"Lagana","year":"2020","journal-title":"Mod Pathol."},{"key":"2023021216111439100_CIT0017","doi-asserted-by":"crossref","first-page":"e13778","DOI":"10.1111\/petr.13778","article-title":"A case of an infant with SARS-CoV-2 hepatitis early after liver transplantation","volume":"24","author":"Heinz","year":"2020","journal-title":"Pediatr Transplant."},{"key":"2023021216111439100_CIT0018","article-title":"COVID-19 associated hepatitis complicating recent living donor liver transplantation [published online April 17, 2020]","author":"Lagana","journal-title":"Arch Pathol Lab Med."},{"key":"2023021216111439100_CIT0019","doi-asserted-by":"crossref","first-page":"1417","DOI":"10.1016\/S0140-6736(20)30937-5","article-title":"Endothelial cell infection and endotheliitis in COVID-19","volume":"395","author":"Varga","year":"2020","journal-title":"Lancet."},{"key":"2023021216111439100_CIT0020","article-title":"Pathological findings in the postmortem liver of COVID-19 patients","author":"Zhao","year":"2021;109:59-68","journal-title":"Hum Pathol."},{"key":"2023021216111439100_CIT0021","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1007\/BF00192114","article-title":"Standardized reporting of histological diagnoses for non-neoplastic liver conditions in needle biopsies","volume":"426","author":"Foschini","year":"1995","journal-title":"Virchows Arch."},{"key":"2023021216111439100_CIT0022","year":"2020"},{"key":"2023021216111439100_CIT0023","year":"2020"},{"key":"2023021216111439100_CIT0024","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/S1084-8592(97)80032-X","article-title":"Optimization of the isolation and amplification of RNA from formalin-fixed, paraffin-embedded tissue: the Armed Forces Institute of Pathology experience and literature review","volume":"2","author":"Krafft","year":"1997","journal-title":"Mol Diagn."},{"key":"2023021216111439100_CIT0025","doi-asserted-by":"crossref","first-page":"2518","DOI":"10.1001\/jama.2020.8907","article-title":"Postmortem examination of patients with COVID-19","volume":"323","author":"Schaller","year":"2020","journal-title":"JAMA."},{"key":"2023021216111439100_CIT0026","doi-asserted-by":"crossref","first-page":"2005","DOI":"10.3201\/eid2609.202095","article-title":"Pathology and pathogenesis of SARS-CoV-2 associated with fatal coronavirus disease, United States","volume":"26","author":"Martines","year":"2020","journal-title":"Emerg Infect Dis."},{"key":"2023021216111439100_CIT0027","article-title":"Liver sinusoidal endothelial cells (LSECs) modifications in patients with chronic hepatitis C [published online June 19, 2020]","author":"Baiocchini","journal-title":"Sci Rep."}],"container-title":["American Journal of Clinical Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ajcp\/article-pdf\/155\/6\/802\/49162428\/aqab009.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ajcp\/article-pdf\/155\/6\/802\/49162428\/aqab009.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,12]],"date-time":"2023-02-12T16:11:30Z","timestamp":1676218290000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ajcp\/article\/155\/6\/802\/6257924"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,29]]},"references-count":27,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2021,4,29]]},"published-print":{"date-parts":[[2021,5,18]]}},"URL":"https:\/\/doi.org\/10.1093\/ajcp\/aqab009","relation":{},"ISSN":["0002-9173","1943-7722"],"issn-type":[{"value":"0002-9173","type":"print"},{"value":"1943-7722","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,6,1]]},"published":{"date-parts":[[2021,4,29]]}}}