Liver Pathology and SARS-CoV-2 Detection in Formalin-Fixed Tissue of Patients with COVID-19

Yevgen Chornenkyy, Melissa Mejia-Bautista, Melanie Brucal, Timothy Blanke, David Dittmann, Anjana Yeldandi, Justin R. Boike, Jon W. Lomasney, Ritu Nayar, Lawrence J. Jennings, Maryam Kherad Pezhouh*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

27 Scopus citations


Objectives: 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. Methods: 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. Results: 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 <. 05) and mild focal lobular activity (6/8, 75%, P =. 06). Conclusions: 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.

Original languageEnglish (US)
Pages (from-to)802-814
Number of pages13
JournalAmerican journal of clinical pathology
Issue number6
StatePublished - Jun 1 2021


  • Autopsy
  • Cytopathology
  • Gastrointestinal
  • Hepatopathology
  • Molecular diagnostics

ASJC Scopus subject areas

  • Pathology and Forensic Medicine


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