Yanny Beshoy, Alkhero Mohammed, Alani Mohammed, Stenberg Daniel, Saharan Aryan, Saab Sammy
University of California, Los Angeles, Los Angeles, CA, USA.
Universal Health Services Southern California Medical Education Consortium, Temecula, CA, USA.
J Clin Exp Hepatol. 2023 May-Jun;13(3):489-499. doi: 10.1016/j.jceh.2022.10.009. Epub 2022 Oct 30.
Post-COVID-19 cholangiopathy (PCC) is a rare but poorly understood and serious complication of COVID-19 infection. We sought to better understand the epidemiology, mechanism of action, histology, imaging findings, and outcomes of PCC.
We searched PubMed, Cochrane Library, Embase, and Web of Science from December 2019 to December 2021. Mesh words used "post-Covid-19 cholangiopathy," "COVID-19 liver injury," "Covid-19 and cholangiopathy," and "COVID-19 liver disease." The data on epidemiology, mechanism of action, histology, imaging findings, and outcomes were collected.
PCC was reported in 30 cases during the study period. The mean (standard deviation [SD]) age was 53.7 (5). Men accounted for cases (83.3%). All patients had required intensive level of care and mechanical ventilation. Mean (SD) number of days from COVID infection to severe disease or liver disease was 63.5 (38). Peak mean (SD) alkaline phosphatase, aspartate aminotransferase, alanine aminotransferase, and total bilirubin were 2014 (831.8) U/L, 1555 (2432.8) U/L, 899.72 (1238.6) U/L, and 10.32 (9.32) mg/dl, respectively. Four patients successfully underwent liver transplantation.
PCC is a severe and progressive complication of COVID-19 infection. More research is needed to better understand the pathophysiology and best treatment approach. Clinicians should suspect PCC in patients with cholestatic liver injury following COVID-19 infection.
新冠后胆管病（PCC）是新冠病毒感染一种罕见但了解不足且严重的并发症。我们试图更好地了解PCC的流行病学、作用机制、组织学、影像学表现及预后。
我们检索了2019年12月至2021年12月期间的PubMed、Cochrane图书馆、Embase和科学网。使用的主题词有“新冠后胆管病”“新冠肝损伤”“新冠与胆管病”及“新冠肝病”。收集了有关流行病学、作用机制、组织学、影像学表现及预后的数据。
研究期间报告了30例PCC病例。平均（标准差[SD]）年龄为53.7（5）岁。男性占病例的83.3%。所有患者均需要重症监护和机械通气。从新冠感染到出现重症疾病或肝病的平均（SD）天数为63.5（38）天。碱性磷酸酶、天冬氨酸转氨酶、丙氨酸转氨酶和总胆红素的平均（SD）峰值分别为2014（831.8）U/L、1555（2432.8）U/L、899.72（1238.6）U/L和10.32（9.32）mg/dl。4例患者成功接受了肝移植。
PCC是新冠病毒感染的一种严重且进行性的并发症。需要更多研究来更好地了解其病理生理学和最佳治疗方法。临床医生应怀疑新冠病毒感染后出现胆汁淤积性肝损伤的患者患有PCC。
