Gastrointestinal and Liver Histopathology in Confirmed SARS-CoV-2 Patients: A Case Series

Background and Objectives: The COVID-19 pandemic, primarily affecting the res-piratory system, has raised questions about its impact on the gastrointestinal (GI) system and liver. Current literature highlights a knowledge gap in understanding the intricate effects of COVID-19 on these organs. This study aims to investigate gastrointestinal and liver histopathol-ogy in confirmed SARS-CoV-2 patients. Methodology: A retrospective study was conducted in 2022, examining pathology slides from 37 COVID-19 patients at Namazi and Abu-Ali Sina hospitals in Shiraz, Iran. The sample pop-ulation comprised all of the cases (37 patients) with confirmed COVID-19 and any type of GI pathology sample for histopathology during the study period. Data included demographics, comorbidities, symptoms, and pathology findings. Results: The study revealed a diverse comorbidity landscape, with 45.9% having no comorbid-ities. Gastritis was prevalent (54.1%), accompanied by ulceration (8.1%) and mucosal edema (21.6%). Among the patients studied, four underwent liver biopsies. The pathological findings from these biopsies included cirrhosis, autoimmune hepatitis, chronic inflammation and fibro-sis, and microvesicular glycogenosis. Conclusion: Gastrointestinal and liver histopathologies in COVID-19 patients were heteroge-neous and nonspecific, possibly influenced by comorbidities. Given the potential of SARS-CoV-2 to infect the enterocytes and hepatocytes and the possible involvement of other factors, such as drugs, ischemia, or preexisting conditions, in the gastrointestinal and liver injury of COVID-19 patients, more research is warranted to better understand the pathogenesis and clin-ical implications of these findings.