Clinical perspectives, assessment, and mechanisms of metabolic-associated fatty liver disease in patients with COVID-19

Table 2 Histological findings from liver biopsies of coronavirus disease 2019 patients

Ref.	Inclusion criteria	Population characteristics n (%)	Histopathological results
Sonzogni et al[89]	Postmortem SARS-CoV-2- positive patients. (n = 48)1; Male/Female (n): 35/131; Age (yr): 71 (32-86)	No comorbidities: 6 (13.3); Hypertension 24 (53.3); Cardiovascular Disease (different than hypertension) 17 (37.8); Diabetes 13 (28.9); Obesity 7 (15.6); Kidney disease 10 (22.2); Pulmonary disease 5 (11.1)	Portal vein parietal fibrosis	Absent 39%; Focal 29%; Multifocal 22%; Diffuse 8%
			Herniated portal vein in periportal parenchyma	Absent 25%; Focal 37%; Multifocal 27%; Diffuse 10%
			Periportal abnormal vessels	Focal 56%; Multifocal 37%; Diffuse 6%
			Fibrosis	Absent 24%; Portal fibrosis 60%; Incomplete fibrous septa 16%
			Lobular inflammation	Absent 50%; Mild 48%; Moderate 2%; Severe 0%
			Portal inflammation	Absent 33%; Mild 66%; Moderate 0%; Severe 0%
			Vascular thrombosis	Partial portal 50%; Complete portal 23%; Incomplete sinusoidal 14%; Complete sinusoidal 12%
			Parenchymal confluent necrosis	Absent 65%; Mild 11%; Moderate 15%; Severe 12%
			Steatosis	Absent 46%; Small droplets 6%; Large droplets 2%; Mixed small and large 46%
Lagana et al[90]	Patients who died from illness related to COVID-19. (n = 40)1; Male/Female (n): 28/121; Age (yr): 70 (66-80)	BMI, N = 32 mean (range) 26.5 (23.9-32.0); Chronic liver disease: 2 (13); Diabetes: 18 (50); Hypertension: 29 (76); Chronic kidney disease: 7 (22); Cardiac disease: 10 (36)	Lobular necroinflammation	20 (50%)
			Portal inflammation	20 (50%)
			Lobular apoptosis (individual hepatocytes)	10 (25%)
			Fat 0%–5%; 6%–33%; 34%–66%; 67%–100%	10 (25%); 19 (48%); 6 (15%); 5 (12%)
			Cholestasis	15 (38%)
Bradley et al[91]	Patients with a positive antemortem or post- mortem SARS-CoV-2. (n = 14)1; Male/Female: 6/81; Age (yr): 73.5 (42-84)	-	Periportal lymphocytic inflammation	2 (14%)
			Centrilobular necrosis	4 (28%)
			Steatosis	9 (64%)
			Congestion	11 (78%)
Falasca et al[92]	Postmortem SARS-CoV-2- positive patients. (n = 22)1; Male/Female: 15/71; Age (yr): 67.9 (27-92)	Chronic obstructive pulmonary disease: 6 (27.2); Cardiac disease: 8 (36.3); Malignancy: 5 (22.7); Hypertension: 4 (18.2); Diabetes: 4 (18.2); Kidney disease: 2 (9.1)	Inflammatory infiltrate	11 (50%)
			Congestion	10 (45.5%)
			Steatosis	12 (54.5%)

¹Age was reported as median (interquartile range). SARS-CoV-2: Severe acute respiratory syndrome coronavirus 2; BMI: Body mass index.