Hepatobiliary long-term consequences of COVID-19: dramatically increased rate of secondary sclerosing cholangitis in critically ill COVID-19 patients

• DOI: 10.1007/s12072-023-10521-0
• Publication Date: 2023-04-29T08:02:18Z
• Authors: Silke Leonhardt; Christian Jürgensen; Josephine Frohme; Donata Grajecki; Andreas Adler; Michael Sigal; Julia Leonhardt; Julian M. Voll; Jan Matthias Kruse; Roland Körner; Kai-Uwe Eckardt; Hans-Joachim Janssen; Volker Gebhardt; Marc D. Schmittner; ; Stefan Hippenstiel; Martin Witzenrath; Norbert Suttorp; Elisa T. Helbig; Lena J. Lippert; Paula Stubbemann; Pinkus Tober-Lau; David Hillus; Sascha S. Haenel; Alexandra Horn; Willi M. Koch; Nadine Olk; Mirja Mittermaier; Fridolin Steinbeis; Tilman Lingscheid; Bettina Temmesfel...; Thomas Zoller; Holger Müller-Red...; Alexander Uhrig; Daniel Grund; Christoph Ruwwe-G...; Miriam S. Stegemann; Katrin M. Heim; Ralf H. Hübner; Christian Drosten; Victor M. Corman; Bastian Opitz; Martin Möckel; Felix Balzer; Claudia Spies; Steffen Weber-Car...; Chantip Dang-Heine; Michael Hummel; Georg Schwanitz; Uwe D. Behrens; Maria Rönnefarth; Sein Schmidt; Alexander Krannich; Saskia Zvorc; Jenny Kollek; Christof von Kalle; Jan Doehn; Christoph Tabeling; Linda Jürgens; Malte Kleinschmidt; Sophy Denker; Moritz Pfeiffer; Belén Millet Pasc...; Luisa Mrziglod; Felix Machleidt; Sebastian Albus; Felix Bremer; Tim Andermann; Carmen Garcia; Philipp Knape; Philipp M. Krause; Liron Lechtenberg; Yaosi Li; Panagiotis Pergantis; Till Jacobi; Teresa Ritter; Berna Yedikat; Lennart Pfannkuch; Christian Zobel; Ute Kellermann; Susanne Fieberg; Laure Bosquillon ...; Anne Wetzel; Markus C. Brack; Moritz Müller-Plathe; Daniel Zickler; Andreas Edel; Britta Stier; Nils B. Müller; Philipp Enghard; Lucie Kretzler; Lil A. Meyer-Arndt; Linna Li; Isabelle Wirsching; Denise Treue; Dana Briesemeister; Jenny Schlesinger; Daniel Wendisch; Anna L. Hiller; Sophie Brumhard; Christian Frey; Hendrik Müller-Ide; Michael Bauer; Charlotte Thibeault; Florian Kurth; Leif Erik Sander; Tobias Müller; Frank Tacke
• Keywords: Sequela; Univariate analysis

Abstract Background Increasing evidence suggests that secondary sclerosing cholangitis (SSC), which can lead to cirrhosis or liver failure, may be a hepatobiliary long-term complication of COVID-19. The aim this study was estimate the frequency and outcome COVID-19 sequela identify possible risk factors. Methods This observational study, conducted at University Hospital Charité Berlin Unfallkrankenhaus Berlin, Germany, involved hospitalized patients with pneumonia, including 1082 ventilated patients. We compared who developed SSC control group by univariate multivariate analyses. Results occurrence after observed exclusively in critically ill invasive ventilation, albeit extreme clustering among them. One every 43 invasively complication. Risk factors preceding development (SSC-CIP) were signs systemic reduced blood oxygen supply (e.g., low PaO 2 /FiO , ischemic organ infarctions), multi-organ failure (high SOFA score) admission, high fibrinogen levels intravenous ketamine use. Multivariate analysis confirmed increased plasma lactate dehydrogenase as independent associated cholangiopathy onset. 1-year transplant-free survival rate COVID-19-associated SSC-CIP 40%. Conclusions causes substantial proportion most likely develops due severe tissue hypoxia fibrinogen-associated circulatory disturbances. A significant increase is expected post-COVID era.