Postmortem Liver Pathology Findings In Patients With Covid-19: A Systematic Review

Abstract

The coronavirus disease 2019 (COVID-19) pandemic quickly became a major public health challenge with extra-pulmonary manifestations, including liver damage. Postmortem examination is crucial for gaining a better understanding of these manifestations and improving the management of patients. This study summarizes the current knowledge of the postmortem liver pathology of patients with COVID-19. This review was conducted according on studies evaluating the postmortem macroscopic and microscopic findings of liver in patients with COVID-19 by searching four electronic databases (PubMed, Scopus, Google Scholar and Web of Science) until June 2021. From the 317 screened articles, 16 articles examining a total of 332 patients who had died with COVID-19 were selected. The major findings of liver were moderate macro and micro vesicular steatosis with mild sinusoidal dilation, active lobular and portal vein thrombosis, mildly-increased lymphocyte filtration in sinusoidal space and multifocal hepatic necrosis. Also, the most common comorbidities were hypertension and other metabolic diseases. In conclusion, liver damage due to COVID-19 infection occurs with various manifestations in patients who have died with COVID-19. Therefore, monitoring liver function during the course and treatment of this disease is necessary for the better management of the patients and to decrease the mortality rate due to COVID-19.