COVID-19 and Hepatic Artery Thrombosis: A Case Report

Brito, Carlos; Filho, José Ricardo Bandeira de Oliveira; Marques, Diogo Torres; Lencastre, Maria do Carmo; Almeida, Jonatas Campos de; Lopes, Edmundo Pessoa de Almeida

doi:10.12659/ajcr.932531

Cited by 8 publications

(6 citation statements)

References 16 publications

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“…In the abdomen, findings of bowel ischemia due to mesenteric and portal vein thrombosis, arterial mesenteric thrombosis and arterial dissections of the splanchnic vessels have been described [ 41 – 44 ]. Few cases of hepatic macrovascular complications including hepatic artery thrombosis and portal vein thrombosis have also been reported [ 45 , 46 ]. However, hepatic macrovascular involvement seems a rare event and none of the patients in our cohort presented with macrovascular changes on imaging.…”

Section: Discussionmentioning

confidence: 99%

Imaging features of COVID-19-associated secondary sclerosing cholangitis on magnetic resonance cholangiopancreatography: a retrospective analysis

et al. 2022

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Background Despite emerging reports of secondary sclerosing cholangitis (SSC) in critically ill COVID-19 patients little is known about its imaging findings. It presents as delayed progressive cholestatic liver injury with risk of progression to cirrhosis. Diagnosis cannot be made based on clinical presentation and laboratory markers alone. Magnetic resonance imaging (MRI) and magnetic resonance cholangiopancreatography (MRCP) can aid in the diagnosis. The aim of this study was to describe MRI/MRCP imaging features of COVID-19-associated SSC. Results Seventeen patients (mean age 60.5 years, 15 male) who underwent MRI/MRCP were included. All had been admitted to intensive care unit (ICU) (median duration of ICU stay 10 weeks, range, 2–28 weeks) and developed acute respiratory distress syndrome requiring mechanical ventilation. On imaging, all patients had intrahepatic bile duct strictures and 10 (58.8%) had associated upstream dilatation. Intrahepatic bile duct beading was seen in 14 cases (82.3%). Only one patient (5.9%) had extrahepatic bile duct stricturing. Patchy arterial phase hyperenhancement and high signal on T2- and diffusion-weighted images were seen in 7 cases (53.8%) and 9 cases (52.9%), respectively. Biliary casts were seen in 2 cases (11.8%). Periportal lymphadenopathy and vascular complications were not seen. Conclusion On MRI/MRCP, COVID-19-associated SSC presents with multiple intrahepatic bile duct strictures with or without upstream dilatation and intrahepatic bile duct beading. Surrounding hepatic parenchymal changes including alterations in enhancement and T2 signal are common. The extrahepatic biliary tree was typically spared and periportal lymphadenopathy was missing in all patients.

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Section: Discussionmentioning

confidence: 99%

Imaging features of COVID-19-associated secondary sclerosing cholangitis on magnetic resonance cholangiopancreatography: a retrospective analysis

et al. 2022

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“…Rare cases of acute liver failure caused by SARS-CoV-2 have been reported 10. Other rare clinical case presentations with liver involvement include febrile hepatitis,11 acute cholecystitis with detection of viral RNA in the gallbladder wall,12 hepatic artery thrombosis13 or an entity called post-COVID-19 cholangiopathy, which is characterised by severe cholestasis and structural bile duct alterations after recovering from life threatening disease 14–16. Interestingly, there have been a very few reports suggesting that COVID-19 infection might reflect ‘a final hit’ leading to de novo manifestation of immune-mediated liver disease such as primary biliary cholangitis (PBC) (one case)17 or autoimmune liver disease (two cases) 18…”

Section: Covid-19: Liver Manifestations and Pathophysiological Aspectsmentioning

confidence: 99%

COVID-19 and liver disease

Dufour

Marjot

Becchetti

et al. 2022

Gut

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Knowledge on SARS-CoV-2 infection and its resultant COVID-19 in liver diseases has rapidly increased during the pandemic. Hereby, we review COVID-19 liver manifestations and pathophysiological aspects related to SARS-CoV-2 infection in patients without liver disease as well as the impact of COVID-19 in patients with chronic liver disease (CLD), particularly cirrhosis and liver transplantation (LT). SARS-CoV-2 infection has been associated with overt proinflammatory cytokine profile, which probably contributes substantially to the observed early and late liver abnormalities. CLD, particularly decompensated cirrhosis, should be regarded as a risk factor for severe COVID-19 and death. LT was impacted during the pandemic, mainly due to concerns regarding donation and infection in recipients. However, LT did not represent a risk factor per se of worse outcome. Even though scarce, data regarding COVID-19 specific therapy in special populations such as LT recipients seem promising. COVID-19 vaccine-induced immunity seems impaired in CLD and LT recipients, advocating for a revised schedule of vaccine administration in this population.

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“…The association between SARS-COV2 and thrombosis has been observed since the first cases were affected by the disease. Several case reports have shown that HAT can happen as a consequence of the infection 11 15. A recurrent form of HAT as a result of COVID-19 was reported in India, which shows the severity of HAT by which the cases might be affected 16…”

Section: Discussionmentioning

confidence: 99%

“…13 14 Even though several cases of post-transplantation HAT have been reported, the correlation between the two incidences have not been studied. 15 16 …”

Section: Introductionmentioning

confidence: 99%

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Does COVID-19 infection significantly affect liver transplantation? Results of liver transplantation in the COVID-19 era at a single, high-volume centre

Moradi

Hadizadeh

Ghiasvand

et al. 2023

BMJ Open Gastroenterol

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BackgroundLiver transplantation is a proven management method for end-stage cirrhosis and is estimated to have increased life expectancy by 15 years. The COVID-19 pandemic posed a challenge to patients who were candid for a solid-organ transplant. It has been suggested that the outcomes of liver transplants could be adversely affected by the infection, as immunosuppression makes liver transplant candidates more susceptible to adverse effects while predisposing them to higher thrombotic events.Material and methodsIn this retrospective study, the cases who received liver transplants from January 2018 to March 2022 were assessed regarding early postoperative mortality rate and hepatic artery thrombosis (HAT) with COVID-19 infection. This study included 614 cases, of which 48 patients were infected.ResultsThis study shows that the early COVID-19-related early postoperative mortality rates substantially increased in the elective setting (OR: 2.697), but the results for the acute liver failure were insignificant. The average model for end-stage liver disease score increased significantly during the pandemic due to new regulations. Although mortality rates increased during the pandemic, the data for the vaccination period show that mortality rates have equalised with the prepandemic era. Meanwhile, COVID-19 infection is assumed to have increased HAT by 1.6 times in the elective setting.ConclusionThis study shows that COVID-19 infection in an acute liver failure poses comparatively little risk; hence transplantation should be considered in such cases. Meanwhile, the hypercoagulative state induced by the infection predisposes this group of patients to higher HAT rates.

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COVID-19 and Hepatic Artery Thrombosis: A Case Report

Cited by 8 publications

References 16 publications

Imaging features of COVID-19-associated secondary sclerosing cholangitis on magnetic resonance cholangiopancreatography: a retrospective analysis

Imaging features of COVID-19-associated secondary sclerosing cholangitis on magnetic resonance cholangiopancreatography: a retrospective analysis

COVID-19 and liver disease

Does COVID-19 infection significantly affect liver transplantation? Results of liver transplantation in the COVID-19 era at a single, high-volume centre

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