GPT and COVID-19: The study suggests that infection with Delta and Omicron viruses directly induces cholangiocyte damage because the receptor for COVID-19 (ACE 2) is expressed more in cholangiocyte than in hepatocytes.[60] Moderate microvascular steatosis and slight lobular activity have also been observed in liver biopsies of patients with COVIFD-19, often presenting clinically as acute hepatitis with elevated AST, ALT, and total bilirubin levels.[61,62]