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. 2024 Mar 30;14(7):745.
doi: 10.3390/diagnostics14070745.

Incidence of Secondary Sclerosing Cholangitis in Hospitalized Long COVID-19 Patients: A Retrospective Single Center Study

Christoph R Werner  1 , Stefano Fusco  1 , Katharina Kienzle  1 , Stefanie Döbele  2 , Kerstin Artzner  1 , Nisar P Malek  1 , Dörte Wichmann  1 , Siri Göpel  1
Affiliations

Incidence of Secondary Sclerosing Cholangitis in Hospitalized Long COVID-19 Patients: A Retrospective Single Center Study

Christoph R Werner et al. Diagnostics (Basel). .

Abstract

Background: SARS-CoV-2 infection and associated COVID-19 disease can lead to critical illness with a risk of developing a multiple organ failure. Subsequently, this may lead to various pathological sequelae, such as secondary sclerosing cholangitis after surviving COVID-19 (SSC-COVID).

Objective: The aim is to retrospectively analyze a cohort of hospitalized patients with first-wave (February 2020-June 2020) SARS-CoV-2 infection and persisting unclear cholangiopathy to determine the incidence of SSC-COVID and its risk factors.

Results: A total of 249 patients were hospitalized at the university hospital in Tübingen, Germany, with SARS-CoV-2 infection during the first wave of the pandemic. Of these, 35.3% (88/249) required intensive care treatment; 16.5% (41/249) of them died due to the complications of COVID-19; 30.8% (64/208) of surviving patients could be followed up und were retrospectively analyzed at our center. The incidence of confirmed SSC-COVID was 7.8% (5/64). All SSC-COVID patients had an ICU stay >20 days, for invasive ventilation, positioning treatment, vasopressor treatment, but possible risk factors for SSC were not significant due to the small number of patients.

Conclusions: SSC-COVID is an emerging disease in post-COVID patients with a high incidence in our single-center cohort. SSC-COVID should be considered as a differential diagnosis, if unclear cholangiopathy or cholestasis persists after SARS-CoV-2 infection.

Keywords: COVID-19; SARS-CoV-2; SSC; incidence; long COVID syndrome; retrospective observational study; secondary sclerosing cholangitis.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Study design. SSC: secondary sclerosing cholangitis; ICU: intensive care unit; COVID: Coronavirus Disease; LTFU: lost to follow-up; SARS-CoV-2: Severe acute respiratory syndrome coronavirus 2.
Figure 2
Figure 2
ERC of patient 1 with destroyed intrahepatic biliary system. The most destroyed area is highlighted with the red circle.
Figure 3
Figure 3
Endoscopic view of patient 1 with extracted sludge and cast (red arrow).
Figure 4
Figure 4
ERC of patient 2 with destroyed intrahepatic biliary system. The most destroyed area is highlighted with the red circle.
Figure 5
Figure 5
Endoscopic findings in SSC-COVID patient 2. The red arrow shows black cast material.
Figure 6
Figure 6
MRCP findings in SSC-COVID patient 2. The most destroyed area is highlighted with the red circle.
Figure 7
Figure 7
MRCP findings in SSC-COVID patient 5. The most destroyed area is highlighted with the red circle.
See this image and copyright information in PMC

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