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Hepatic Involvement as Hyperbilirubinemia in Patients with COVID-19: Case Series from Iran
Ahmad Hormati1, Mohammad Reza Ghadir2, Mohammad Saeidi3
1Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran,Iran.
Insights
Pure hyperbilirubinemia, a rare gastrointestinal symptom, was observed in patients with COVID-19. Gastroenterologists should recognize this hepatic involvement as a potential indicator of severe COVID-19 pneumonia.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Hepatology
Background:
- The COVID-19 pandemic led to an increase in patients presenting with gastrointestinal symptoms.
- Gastroenterology clinics encountered numerous patients suspected of SARS-CoV-2 infection.
Observation:
- A notable incidence of pure hyperbilirubinemia, a rare GI manifestation, was observed among patients referred to clinics.
- This case series details clinical data from COVID-19 patients admitted to Shahid Beheshti Hospital in Qom city.
Findings:
- Pure hyperbilirubinemia can be considered a rare gastrointestinal symptom of COVID-19.
- Other gastrointestinal enzyme levels may remain within normal ranges despite hyperbilirubinemia.
Implications:
- Gastrointestinal physicians must be aware of hepatic involvement, specifically pure hyperbilirubinemia, in COVID-19 patients.
- Recognizing this symptom is crucial for prognosis and management of COVID-19 pneumonia.
- Early identification and addressing of hepatic involvement in new GI clinic referrals are recommended.
Background:
After the spread of novel coronavirus disease 2019 (COVID-19) from Wuhan to Iran, gastroenterology clinics, was faced with a large number of patients who were suspected of being infected with the SARS-CoV-2. Among refereed patient, the incidence of pure hyperbilirubinemia as rare gastrointestinal (GI) symptoms was obvious.
Methods:
In this case series, we have reported the clinical data in details for patients with COVID-19 who have been admitted to the Shahid Beheshti Hospital in Qom city, from 3 March to 3 August 2020. COVID infection, be confirmed by using real-time reverse-transcriptase polymerase chain reaction (rRT-PCR) and chest computed tomography (CT) scan, as well.
Results:
According to the clinical findings, pure hyperbilirubinemia may consider as rare gastrointestinal (GI) symptom of COVID-19. However, it is possible that the other GI enzymes values fall in to the normal range.
Conclusion:
In some infected patients, GI physicians may face hepatic involvement as pure hyperbilirubinemia. At the age of COVID-19 crisis, all GI physicians should be aware of the possible occurrence of hepatic involvement as an important prognosis of COVID pneumonia and it should be exactly addressed in new referred patients to GI clinic.
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