Postmortem Liver Pathology Findings in Patients With COVID-19: A Systematic Review

Abstract

Background: The Coronavirus Disease 2019 (COVID-19) pandemic promptly became a significant public health challenge with extra-pulmonary manifestations, including liver damage. Postmortem examination is crucial for gaining a better understanding of these manifestations and improving patient management. This study summarized the current knowledge of the postmortem liver pathology of patients with COVID-19. Methods: This review was conducted on studies evaluating the postmortem macroscopic and microscopic findings of the liver in patients with COVID-19. Accordingly, we searched 4 electronic databases (PubMed, Scopus, Google Scholar, & Web of Science) until June 2021. From the 317 screened articles, 16 articles examining a total of 332 patients who had died due to COVID-19 were selected. Results: The significant findings of the liver were moderate macro and microvesicular steatosis with mild sinusoidal dilation, active lobular and portal vein thrombosis, mildly-increased lymphocyte filtration in sinusoidal space, and multifocal hepatic necrosis. Additionally, the most common comorbidities were hypertension and other metabolic diseases. In conclusion, liver damage due to COVID-19 infection has various manifestations in patients who have expired due to COVID-19. Conclusion: Therefore, monitoring liver function during the course and treatment of this disease is necessary for better patient management and to decrease the COVID-19-induced mortality rate COVID.