Cuban scientists have conducted an in-depth analysis of liver samples from 559 individuals who succumbed to COVID-19, revealing significant occurrences of hepatocellular necrosis, fibrosis, and other abnormalities. This research aims to shed light on the liver damage inflicted by the virus and guide the management of patients with liver conditions.
The results and background of this investigation were shared on Saturday by Armando Rodríguez Batista, Minister of Science, Technology, and Environment (CITMA), in a Facebook post, drawing from insights provided by Dr. Licet González Fabián, a Second-Degree Specialist in Pathological Anatomy at the Institute of Gastroenterology.
This study is part of a broader project initiated during the pandemic and has been recognized with an award from the Cuban Academy of Sciences, as noted by Rodríguez. Other works stemming from nearly 800 autopsies performed by the team were also honored by the institution in 2022 and 2024.
Research Methodology and Findings
According to a scientific article published in the journal Metabolism and Target Organ Damage, clinical data and histological liver samples were collected from 800 COVID-19 deceased between 2020 and 2022, out of a total of 1,290 virus-related deaths reported in Havana during that period.
From October 2021, liver pathology specialists formally joined the research team, and 563 samples underwent detailed histopathological examination. Four samples were excluded due to quality issues or incomplete clinical information, leaving a final cohort of 559 deceased individuals.
The observational, descriptive, and cross-sectional liver-specific study included patients aged 19 and older who had confirmed SARS-CoV-2 infection via PCR and died during hospitalization. The analysis spanned from October 2021 to December 2022.
Significant Findings on Liver Damage
Minimally invasive autopsies were carried out at two designated centers: the Dr. Luis Díaz Soto Clinical-Surgical Hospital and the Salvador Allende Clinical-Surgical Hospital. Samples were then processed at the central Pathological Anatomy laboratory of the Institute of Gastroenterology in Havana.
Results showed that 486 of the 559 deceased, equating to 87%, exhibited hepatocellular necrosis, indicating the death of the liver’s main cells. Specifically, confluence necrosis was observed in 285 instances, representing 51% of the cases.
Among other findings, 271 patients, or 48.5%, showed hepatic fibrosis; 237, or 42.4%, had steatotic liver disease; and 29, or 5.2%, presented with cirrhosis. Cellular apoptosis, Kupffer cell hyperplasia and hypertrophy, and sinusoidal congestion were also frequently observed.
Statistical analysis identified steatotic liver disease and cirrhosis as independent predictors linked to a higher likelihood of hepatocellular necrosis within the studied population.
Ongoing Research and Implications
Researchers maintained caution in interpreting the results, noting that the study describes observed associations in deceased individuals and does not independently establish a causal link between each hepatic change and COVID-19 mortality.
Dr. González stressed the continued relevance of these investigations beyond the pandemic's critical phase, as findings may assist in monitoring those who suffered severe forms of the disease. "COVID-19 remains a concern in scientific terms," she stated, highlighting the potential utility of the data for gastroenterologists and hepatologists treating patients with a history of liver disease or severe COVID-19 episodes.
The scientific article concludes that the results underscore the need for close monitoring of liver function in patients with pre-existing liver conditions during and after SARS-CoV-2 infection.
Cuba had already initiated research into the potential long-term effects of the disease. In January 2021, a team of over 40 specialists began examining possible renal sequelae in COVID-19 survivors, including those who experienced asymptomatic, mild, severe, and critical cases.
Persistent effects in recovered patients were also documented. In February of the same year, Cuban nurse Yaquelín Collado Rodríguez shared her ongoing struggles nearly nine months after hospital discharge, following a 59-day hospitalization, 37 of which were in intensive care.
Understanding Liver Impact from COVID-19
What did the Cuban study on COVID-19 and liver damage find?
The study found a high incidence of hepatocellular necrosis, fibrosis, and other liver abnormalities in 559 individuals who died from COVID-19.
Why is liver function monitoring important in COVID-19 patients?
Monitoring liver function is crucial because pre-existing liver conditions can be exacerbated by COVID-19, leading to severe complications.
What were the main liver abnormalities observed in the study?
The main abnormalities included hepatocellular necrosis, hepatic fibrosis, steatotic liver disease, and cirrhosis.