Liver Transplantation in 3 Cholestatic Infants With History of COVID Exposure
- Shruti Sakhuja 1, Kalyani R Patel 2, Matthew Goss 3, Flor M Munoz 4, Garrett Wortham 5, Megan Crawford 5, John A Goss 6, Nhu Thao Galvan 6
- 1Department of Pediatrics, Division of Gastroenterology, Hepatology, and Nutrition, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA.
- 2Department of Pathology, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA.
- 3McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA.
- 4Department of Pediatrics, Division of Infectious Diseases, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA.
- 5Baylor College of Medicine, Houston, TX, USA.
- 6Department of Surgery, Division of Abdominal Transplantation, Baylor College of Medicine, Houston, TX, USA.
- 0Department of Pediatrics, Division of Gastroenterology, Hepatology, and Nutrition, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA.
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March 28, 2025
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View abstract on PubMed
Summary
This summary is machine-generated.Perinatal SARS-CoV-2 exposure may be linked to biliary atresia (BA) in infants, causing persistent cholestasis and liver failure. Further research is needed to confirm causality and understand the role of exposure timing in prognosis.
Area Of Science
- Hepatology
- Neonatology
- Infectious Diseases
Background
- COVID-19 infection during pregnancy poses risks, including liver injury.
- SARS-CoV-2 can affect the liver through direct viral effects, cytokine storm, and hypoxic injury.
- Cholangiopathy and persistent cholestasis are known complications of COVID-19 in adults.
Purpose Of The Study
- To describe three infants with perinatal SARS-CoV-2 exposure who presented with persistent cholestasis.
- To investigate the potential association between perinatal SARS-CoV-2 exposure and atypical biliary atresia (BA).
- To highlight the progression to liver failure and need for liver transplantation in affected infants.
Main Methods
- Case series describing three infants with perinatal SARS-CoV-2 exposure.
- Clinical presentation including persistent cholestasis and low Gamma-Glutamyl Transferase (GGT) levels.
- Histologic examination revealing extrahepatic biliary obstruction suggestive of BA.
Main Results
- All three infants developed persistent cholestasis and liver failure.
- Histology indicated extrahepatic biliary obstruction, consistent with biliary atresia (BA).
- All patients required liver transplantation within their first year of life.
Conclusions
- Perinatal SARS-CoV-2 exposure may be associated with atypical biliary atresia (BA) in infants.
- Infants with this condition can progress to advanced liver disease and liver failure, even without severe COVID-19 infection.
- Further studies are required to establish causality and explore the impact of exposure timing on prognosis.
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