Division of Hepatology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, USA.
Division of Infectious Diseases, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, USA.
Am J Gastroenterol. 2021 May 1;116(5):1077-1082. doi: 10.14309/ajg.0000000000001154.
Liver chemistry abnormalities are a frequent manifestation of coronavirus disease 2019 (COVID-19) but are usually transient and resolve with disease resolution.
We describe the clinical course and histologic features of 3 adults who developed prolonged and severe cholestasis during recovery from critical cardiopulmonary COVID-19.
These patients had clinical and histologic features similar to secondary sclerosing cholangitis of the critically ill patient, but with unique histologic features including severe cholangiocyte injury and intrahepatic microangiopathy suggestive of direct hepatic injury from COVID-19.
We believe that these cases constitute a novel severe post-COVID-19 cholangiopathy with potential for long-term hepatic morbidity.
肝化学异常是 2019 年冠状病毒病（COVID-19）的常见表现，但通常是短暂的，随着疾病的缓解而消退。
我们描述了 3 例在从严重心肺 COVID-19 康复过程中发生长期和严重胆汁淤积的成年人的临床过程和组织学特征。
这些患者具有与危重病患者继发性硬化性胆管炎相似的临床和组织学特征，但具有独特的组织学特征，包括严重的胆管细胞损伤和提示 COVID-19 直接肝损伤的肝内微血管病。
我们认为这些病例构成了一种新的严重 COVID-19 后胆管病，可能存在长期肝损伤的风险。
