Liver histopathology in severe COVID 19 respiratory failure is suggestive of vascular alterations
This article has been Reviewed by the following groups
Discuss this preprint
Start a discussion What are Sciety discussions?Listed in
- Evaluated articles (ScreenIT)
Abstract
SARS2‐CoV‐2 breakout in Italy caused a huge number of severely ill patients with a serious increase in mortality. Although lungs seem to be the main target of the infection, very few information are available about liver involvement, possibly evocating a systemic disease. Post‐mortem wedge liver biopsies from 48 patients died from severe pulmonary COVID‐19 disease with respiratory failure were collected from two main hospitals in northern Italy. No patient had clinical symptoms of liver disease or signs of liver failure before and during hospitalization; for each of them liver function tests were available. All liver samples showed minimal inflammation features. Histological pictures compatible with vascular alterations were observed, characterized by increase in number of portal vein branches associated with lumen massive dilatation, partial or complete luminal thrombosis of portal and sinusoidal vessels, fibrosis of portal tract, focally markedly enlarged and fibrotic. SARS‐CoV‐2 was found in 15 of 22 samples tested by in situ hybridization method. Our preliminary results confirm the clinical impression that liver failure is not a main concern and this organ is not the target of significant inflammatory damage. Histopathological findings are highly suggestive for marked derangement of intrahepatic blood vessel network secondary to systemic changes induced by virus that could target not only lung parenchyma but also cardiovascular system, coagulation cascade and endothelial layer of blood vessels. It still remains unclear if the mentioned changes are directly related to virus infection or if SARS‐CoV‐2 triggers a series of reactions leading to striking vascular alterations.
Article activity feed
-
-
SciScore for 10.1101/2020.05.06.20092718: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement not detected. Randomization A medium of two tissue blocks were taken random from each liver as macroscopic aspect was normal; the size of all the blocks obtained were comparable. Blinding Each wedge liver sample contained at least 20 portal fields; histological examination was performed blindly by experienced pathologists confident with liver non neoplastic histopathology. Power Analysis not detected. Sex as a biological variable Wedge liver sample were obtained post-mortem in 48 COVID-19 positive patients ( 35 males, 13 females; medium age 71,2 years; range 87-32 years), all of them deceased for severe respiratory failure after a variable duration of hospitalization, … SciScore for 10.1101/2020.05.06.20092718: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement not detected. Randomization A medium of two tissue blocks were taken random from each liver as macroscopic aspect was normal; the size of all the blocks obtained were comparable. Blinding Each wedge liver sample contained at least 20 portal fields; histological examination was performed blindly by experienced pathologists confident with liver non neoplastic histopathology. Power Analysis not detected. Sex as a biological variable Wedge liver sample were obtained post-mortem in 48 COVID-19 positive patients ( 35 males, 13 females; medium age 71,2 years; range 87-32 years), all of them deceased for severe respiratory failure after a variable duration of hospitalization, ranging from 1 to 21 days (median duration 7 days); sampling procedure was partial autopsy limited to lungs, heart and liver in 30 patients and a complete autopsy in 18 cases excluding brain. Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We found bar graphs of continuous data. We recommend replacing bar graphs with more informative graphics, as many different datasets can lead to the same bar graph. The actual data may suggest different conclusions from the summary statistics. For more information, please see Weissgerber et al (2015).
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
-
