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High prevalence of hepatic steatosis and vascular thrombosis in COVID-19:A systematic review and meta-analysis of autopsy data

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World Journal of Gastroenterology 2020年第48期26卷 7693-7706页

作者： Luis Antonio Díaz Francisco Idalsoaga macarena cannistra Roberto Candia Daniel Cabrera Francisco Barrera Alejandro Soza Rondell Graham Arnoldo Riquelme Marco Arrese Michael D Leise Juan Pablo Arab Department of Gastroenterology Escuela de MedicinaPontificia Universidad Católica de ChileSantiago 8320000Chile Department of Internal Medicine Pontificia Universidad Católica de ChileSantiago 8320000Chile School of Medicine Pontificia Universidad Católica de ChileSantiago 8320000Chile Facultad de Ciencias Médicas Universidad Bernardo O'HigginsSantiago 8320000Chile Department of Laboratory Medicine and Pathology Mayo Clinic RochesterMinnesotaMN 55902United States Católica de Chile Santiago 8320000Chile Division of Gastroenterology and Hepatology Mayo Clinic RochesterMinnesotaMN 55905United States

BACKGROUND Coronavirus disease 2019(COVID-19)disease can frequently affect the *** on hepatic histopathological findings in COVID-19 is *** To characterize hepatic pathological findings in patients with *** We conducted a systematic review with meta-analysis registered on PROSPERO(CRD42020192813),following PRISMA *** trials were those including patients of any age and COVID-19 diagnosis based on a molecular *** reports from deceased COVID-19 patients undergoing autopsy or liver biopsy were *** including less than ten patients were *** were pooled using random-effects models.Q statistic and I2 were used to assess heterogeneity and levels of evidence,*** We identified 18 studies from 7 countries;all were case reports and case series from *** the patients were over 15 years old,and 67.2%were *** performed a meta-analysis of 5 studies,including 116 *** prevalence estimates of liver histopathological findings were hepatic steatosis 55.1%[95%confidence interval(CI):46.2-63.8],congestion of hepatic sinuses 34.7%(95%CI:7.9-68.4),vascular thrombosis 29.4%(95%CI:0.4-87.2),fibrosis 20.5%(95%CI:0.6-57.9),Kupffer cell hyperplasia 13.5%(95%CI:0.6-54.3),portal inflammation 13.2%(95%CI:0.1-48.8),and lobular inflammation 11.6%(95%CI:0.3-35.7).We also identified the presence of venous outflow obstruction,phlebosclerosis of the portal vein,herniated portal vein,periportal abnormal vessels,hemophagocytosis,and *** We found a high prevalence of hepatic steatosis and vascular thrombosis as major histological liver *** frequent findings included portal and lobular inflammation and Kupffer cell hyperplasia or *** studies are needed to establish the mechanisms and implications of these findings.

关键词： Pathology SARS-CoV-2 COVID-19 Autopsies Liver Liver biopsies

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