Mayorquín-Aguilar JM, Lara-Reyes A, Revuelta-Rodríguez LA, Flores-García NC, Ruiz-Margáin A, Jiménez-Ferreira MA, Macías-Rodríguez RU. Secondary sclerosing cholangitis after critical COVID-19: Three case reports. World J Hepatol 2022; 14(8): 1678-1686 [PMID: 36157873 DOI: 10.4254/wjh.v14.i8.1678]
Corresponding Author of This Article
Ricardo Ulises Macías-Rodríguez, MSc, PhD, Assistant Professor, Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Col. Belisario Domínguez Sección XVI, Mexico City 14080, Mexico. ricardomacro@yahoo.com.mx
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Hepatol. Aug 27, 2022; 14(8): 1678-1686 Published online Aug 27, 2022. doi: 10.4254/wjh.v14.i8.1678
Secondary sclerosing cholangitis after critical COVID-19: Three case reports
Juan M Mayorquín-Aguilar, Aldo Lara-Reyes, Luis Alberto Revuelta-Rodríguez, Nayelli C Flores-García, Astrid Ruiz-Margáin, Marco Antonio Jiménez-Ferreira, Ricardo Ulises Macías-Rodríguez
Juan M Mayorquín-Aguilar, Aldo Lara-Reyes, Luis Alberto Revuelta-Rodríguez, Nayelli C Flores-García, Astrid Ruiz-Margáin, Ricardo Ulises Macías-Rodríguez, Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, Mexico
Marco Antonio Jiménez-Ferreira, Department of Pathology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, Mexico
Author contributions: Mayorquín-Aguilar JM, Lara-Reyes A, and Revuelta-Rodríguez LA were the patient´s gastroenterology fellows during their hospitalization; Macías-Rodríguez RU and Flores-García NC were the attending hepatologists; Mayorquin-Aguilar JM, Lara-Reyes A, Macías-Rodríguez RU, and Ruiz-Margain A reviewed the literature and contributed to the manuscript drafting; Jiménez-Ferreira MA was the gastrointestinal pathology fellow in charge of the interpretation and handling of the pathology images.
Informed consent statement: The cases included in this manuscript signed a general informed consent, provided to all patients admitted to our institution with the diagnosis of severe COVID-19. In the manuscript no information regarding ID, name or physical characteristics allowing recognizing the identity of the patients is provided.
Conflict-of-interest statement: All authors have no conflicts of interest to declare.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ricardo Ulises Macías-Rodríguez, MSc, PhD, Assistant Professor, Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Col. Belisario Domínguez Sección XVI, Mexico City 14080, Mexico. ricardomacro@yahoo.com.mx
Received: January 28, 2022 Peer-review started: January 28, 2022 First decision: March 25, 2022 Revised: April 4, 2022 Accepted: August 15, 2022 Article in press: August 15, 2022 Published online: August 27, 2022 Processing time: 210 Days and 7.9 Hours
Abstract
BACKGROUND
The global coronavirus disease 2019 (COVID-19) pandemic has caused more than 5 million deaths. Multiorganic involvement is well described, including liver disease. In patients with critical COVID-19, a new entity called "post-COVID-19 cholangiopathy" has been described.
CASE SUMMARY
Here, we present three patients with severe COVID-19 that subsequently developed persistent cholestasis and chronic liver disease. All three patients required intensive care unit admission, mechanical ventilation, vasopressor support, and broad spectrum antibiotics due to secondary infections. Liver transplant protocol was started for two of the three patients.
CONCLUSION
Severe COVID-19 infection should be considered a potential risk factor for chronic liver disease and liver transplantation.
Core Tip: Coronavirus disease 2019 (COVID-19) multiorganic involvement is well described, including liver disease. In patients with critical COVID-19 requiring invasive mechanical ventilation and management in the intensive care unit, a new entity called “post-COVID-19 cholangiopathy” has been described. It is characterized by persistent cholestasis and chronic liver disease. Therefore, severe COVID-19 infection should be considered a potential risk factor for chronic liver disease probably requiring liver transplantation.
