This striking observation was validated by connective tissue stains and conventional immunohistochemistry and morphometry for CK19 + ducts, clearly showing various degrees of ductular reaction and associated a-SMA + myofibroblast activation, consistent with emerging reports of COVID-19-induced sclerosing cholangitis (fibrotic disease of bile ducts) [83], which in most severe cases may require liver transplantation [84]. Here, KRT19 is linked to sclerosing cholangitis.