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Post-COVID-19 Cholangiopathy: A Systematic Review
Beshoy Yanny1, Mohammed Alkhero2, Mohammed Alani2
1University of California, Los Angeles, Los Angeles, CA, USA.
Journal of Clinical and Experimental Hepatology
|November 7, 2022
Summary
Post-COVID-19 cholangiopathy (PCC) is a severe complication of COVID-19. This study investigated 30 cases, revealing significant liver enzyme elevations and the need for further research into its pathophysiology and treatment.
Area of Science:
- Hepatology
- Infectious Diseases
- Gastroenterology
Background:
- Post-COVID-19 cholangiopathy (PCC) is a rare, severe complication of SARS-CoV-2 infection.
- The epidemiology, pathogenesis, and clinical course of PCC remain poorly understood.
Purpose of the Study:
- To elucidate the characteristics of Post-COVID-19 cholangiopathy.
- To understand the epidemiology, mechanism of action, histology, imaging findings, and outcomes of PCC.
Main Methods:
- A systematic literature search was conducted across PubMed, Cochrane Library, Embase, and Web of Science from December 2019 to December 2021.
- Data extraction focused on epidemiological factors, mechanisms, histology, imaging, and patient outcomes.
Main Results:
- Thirty cases of PCC were identified, predominantly affecting men (83.3%) with a mean age of 53.7 years.
- All affected patients required intensive care and mechanical ventilation, with a mean of 63.5 days from COVID-19 infection to severe liver disease.
- Significant elevations in liver enzymes (alkaline phosphatase, AST, ALT) and bilirubin were observed; four patients underwent liver transplantation.
Conclusions:
- Post-COVID-19 cholangiopathy is a serious and progressive condition following COVID-19 infection.
- Further research is crucial to understand PCC pathophysiology and optimal management strategies.
- Clinicians should maintain a high index of suspicion for PCC in patients presenting with cholestatic liver injury post-COVID-19.
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