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©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
Post-COVID-19 cholangiopathy: A systematic review
Maddalena Zippi, Sirio Fiorino, Wandong Hong, Dario de Biase, Claudio Giuseppe Gallo, Alfonso Grottesi, Annamaria Centorame, Pietro Crispino
Maddalena Zippi, Unit of Gastroenterology and Digestive Endoscopy, Sandro Pertini Hospital, Rome 00157, Italy
Sirio Fiorino, Unit of Internal Medicine, Maggiore Hospital, Local Health Unit of Bologna, Bologna 40133, Italy
Wandong Hong, Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325035, Zhejiang Province, China
Dario de Biase, Department of Pharmacy and Biotechnology, University of Bologna, Bologna 40126, Italy
Claudio Giuseppe Gallo, Unit of Internal Medicine, Emilian Physiolaser Therapy Center, Bologna 40024, Italy
Alfonso Grottesi, Unit of General Surgery, Sandro Pertini Hospital, Rome 00157, Italy
Annamaria Centorame, Department of Nursing Sciences, University of Foggia, Foggia 71122, Italy
Pietro Crispino, Unit of Emergency Medicine, Santa Maria Goretti Hospital, Latina 04100, Italy
Author contributions: Zippi M, Fiorino S and Crispino P made substantial contributions to study conception and design; Hong W, de Biase D, Gallo CG, Centorame A and Grottesi A were involved in acquisition, analysis and interpretation of data; Zippi M, Fiorino S and Crispino P were involved in drafting the article, revising it critically for important intellectual content and gave the final approval of the version to be published.
Conflict-of-interest statement: The authors declare having no conflicts of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
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: Maddalena Zippi, PhD, Doctor, Unit of Gastroenterology and Digestive Endoscopy, Sandro Pertini Hospital, Via dei Monti Tiburtini 385, Rome 00157, Italy. maddalena.zippi@aslroma2.it
Received: August 25, 2022
Peer-review started: August 25, 2022
First decision: October 4, 2022
Revised: October 13, 2022
Accepted: November 23, 2022
Article in press: November 23, 2022
Published online: January 12, 2023
BACKGROUND
The recent and still ongoing pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) entailed various long-term complications, including post-infectious cholangiopathy.
AIM
To identify the available studies concerning post-coronavirus disease 2019 (COVID-19) cholangiopathy.
METHODS
An extensive bibliographical search was carried out in PubMed and in Cochrane Library to identify the articles (retrospective and prospective studies, cohort studies, case series and case reports) published between January 1, 2020 and August 22, 2022, using both MeSH terms and free-language keywords: cholangiopathy; COVID-19; post-COVID-19 cholangiopathy; SARS-CoV-2.
RESULTS
Thirteen studies fulfilled the inclusion criteria, which included 64 patients suffering from this condition. The patients were male in 82.8% of cases. Liver transplant was executed in 6 patients and scheduled in 7 patients, while 2 patients refused the surgical approach. Therefore in 23.4% of the cases, performing this procedure appeared to be necessary.
CONCLUSION
This review has revealed that generally the involvement of the liver in the course of SARS-CoV-2 infection is mild and transient, inducing cholestasis of cholangiocytes but can also be severe enough to cause organ failure in some cases.
Core Tip: As severe acute respiratory syndrome coronavirus 2 infection keeps spreading, its long-term complications, like cholangiopathy, will manifest. Post-coronavirus disease 2019 (COVID-19) cholangiopathy is most commonly identified in patients hospitalized in the intensive care unit and shows histological characteristics reminiscent of secondary sclerosing cholangitis. Post-COVID-19 cholangiopathy represents a serious complication that may evolve into liver failure, even requiring transplant.
