Characteristics and Mechanism of Liver Injury in 2019 Coronavirus Disease

Li, Jie; Fan, Jian-Gao

Abnormal liver biochemistries have also been reported in patients with SARS and MERS, 26, 27 implying that potential liver injury is closely associated with corona virus infection. But it's unclear whether the liver injury can be caused directly by the coronavirus itself. It is well known that SARS-CoV-2 is closely related to SARS-CoV, and they share the same receptor, angiotensin converting enzyme 2 (ACE2), and lung is the main target organ of the corona virus infection. Previous RNAseq data in the human protein atlas database demonstrates expression of ACE2 in the liver. 28 However, only a low frequency of ACE2 expression is observed in cholangiocytes, but not in hepatocytes, Kupffer cells, and endothelial cells. 29 Recently, the single-cell RNA-seq data from two independent cohorts suggest cholangiocyte-specific expression of ACE2 in human liver samples. Similarly, single cell sequencing and immunohistochemistry study showed that ACE2 was only expressed in bile duct epithelial cells of normal liver tissues, and very minimally in hepatocytes.