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. 2022 Jan 1;14(1):e2022003. doi: 10.4084/MJHID.2022.003

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This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Routes of SARS-CoV-2 infecting liver. SARS-CoV-2 entered the airway epithelial cells and alveoli. Due to a large number of viral replication and the accumulation of a variety of pro-inflammatory cytokines and chemokines, the alveolar epithelial cells were damaged with reactive proliferation, shedding. SARS-CoV-2 can diffuse from the damaged alveoli into the capillaries and spread through the blood circulation. After SARS-CoV-2 invades the intestinal tract, it can damage the intestinal mucosal epithelium and vascular barrier, and enters the liver through the portal vein. Then SARS-CoV-2 can reach bile through intercellular vesicle pathway after the virus infects hepatocytes. SARS-CoV-2 may reach and infect the intestine through the bile, and then cause the secondary infection of the intestine.