S1655 COVID-19-Induced Persistent Jaundice With Secondary Sclerosing Cholangitis

Kobeszko, Matthew; Kumar, Nilay

doi:10.14309/01.ajg.0000780152.04292.21

Cited by 3 publications

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“…A study presented the case of a patient who continued to have chronic cholestasis and liver injury after severe sepsis connected to COVID-19 [ 75 ]. The diagnosis of SSC was established after a liver biopsy, and ursodiol 250 mg three times a day was administered.…”

Section: Covid-19 and Cholangitismentioning

confidence: 99%

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Risk of New-Onset Liver Injuries Due to COVID-19 in Preexisting Hepatic Conditions—Review of the Literature

Bucurica

Radu²,

Bucurica³

et al. 2022

Medicina

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The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) impacted the world and caused the 2019 coronavirus disease (COVID-19) pandemic. The clinical manifestations of the virus can vary from patient to patient, depending on their respective immune system and comorbidities. SARS-CoV-2 can affect patients through two mechanisms: directly by targeting specific receptors or by systemic mechanisms. We reviewed data in the latest literature in order to discuss and determine the risk of new-onset liver injuries due to COVID-19 in preexisting hepatic conditions. The particular expression of angiotensin-converting enzyme 2 (ACE2) receptors is an additional risk factor for patients with liver disease. COVID-19 causes more severe forms in patients with non-alcoholic fatty liver disease (NAFLD), increases the risk of cirrhosis decompensation, and doubles the mortality for these patients. The coinfection SARS-CoV-2—viral hepatitis B or C might have different outcomes depending on the stage of the liver disease. Furthermore, the immunosuppressant treatment administered for COVID-19 might reactivate the hepatic virus. The high affinity of SARS-CoV-2 spike proteins for cholangiocytes results in a particular type of secondary sclerosing cholangitis. The impact of COVID-19 infection on chronic liver disease patients is significant, especially in cirrhosis, influencing the prognosis and outcome of these patients.

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Section: Covid-19 and Cholangitismentioning

confidence: 99%

“…The diagnosis of SSC was established after a liver biopsy, and ursodiol 250 mg three times a day was administered. After 6 months, the patient was discharged, and jaundice and elevated liver enzymes were ameliorated, but still persistently elevated [ 75 ].…”

Section: Covid-19 and Cholangitismentioning

confidence: 99%

Risk of New-Onset Liver Injuries Due to COVID-19 in Preexisting Hepatic Conditions—Review of the Literature

Bucurica

Radu²,

Bucurica³

et al. 2022

Medicina

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Deranged Liver Function in a Critically Ill Patient With COVID-19: A Cautionary Case

Martin,

Smale,

Grillas

2023

Gastroenterology

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Distinct histopathological features of post-COVID-19 cholangiopathy

Borges,

Cotrim,

Andrade

et al. 2024

Preprint

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Background: Cholangiopathy has been described in survivors of severe COVID-19, presenting significant clinical parallels to the pre-pandemic condition of secondary sclerosing cholangitis in critically ill patients (SSC-CIP). Aim: Herein, we examined the liver histopathology of individuals with persistent cholestasis following severe COVID-19. Methods: Post-COVID-19 cholestasis liver samples were subjected to routine staining techniques and cytokeratin 7 immunostaining, and the portal and parenchymal changes were semi-quantitatively analyzed. Results: All ten patients, five men, median age 56, interquartile range (IQR) 51–60, requiring mechanical ventilation. The median and IQR liver enzyme concentrations proximal to biopsy were in IU/L: ALP, 605 (390–1,105); GGT, 925 (776–2,169); ALT, 92 (86–110); AST, 90 (68–108); and bilirubin, 3 (1–6) mg/dL. Imaging revealed intrahepatic bile duct anomalies and biliary casts. Biopsies were performed at a median of 203 (150–249) days after molecular confirmation of infection. Portal and periportal fibrosis, moderate-to-severe ductular proliferation, and bile duct dystrophy were found in all patients, while hepatocyte biliary metaplasia was observed in all tested cases. Mild-to-severe parenchymal cholestasis and bile plugs were observed in nine and six cases. Mild swelling of the arteriolar endothelial cells was observed in five patients. A thrombus in a small portal vein branch and mild periductal fibrosis were observed in one case each. One patient developed multiple small biliary infarctions. Ductopenia was not observed in any patient. Conclusions: The alterations were similar to those observed in SSC-CIP; however, pronounced swelling of endothelial cells, necrosis of the vessel walls, and thrombosis in small vessels were notable.

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S1655 COVID-19-Induced Persistent Jaundice With Secondary Sclerosing Cholangitis

Cited by 3 publications

References 0 publications

Risk of New-Onset Liver Injuries Due to COVID-19 in Preexisting Hepatic Conditions—Review of the Literature

Risk of New-Onset Liver Injuries Due to COVID-19 in Preexisting Hepatic Conditions—Review of the Literature

Deranged Liver Function in a Critically Ill Patient With COVID-19: A Cautionary Case

Distinct histopathological features of post-COVID-19 cholangiopathy

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