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COVID-19-Related Cholangiopathy: Histological Findings.
Borges, Valéria F A; Cotrim, Helma P; Andrade, Antônio Ricardo C F; Mendes, Liliana S C; Penna, Francisco G C; Silva, Marcelo C; Salomão, Frederico C; Freitas, Luiz A R.
Afiliação
  • Borges VFA; Postgraduate Program in Medicine and Health, Federal University of Bahia, Salvador 40026-010, Brazil.
  • Cotrim HP; School of Medicine of Bahia, Federal University of Bahia, Salvador 40026-010, Brazil.
  • Andrade ARCF; School of Medicine of Bahia, Federal University of Bahia, Salvador 40026-010, Brazil.
  • Mendes LSC; Hospital de Base do Distrito Federal, Brasilia 70330-150, Brazil.
  • Penna FGC; Department of Internal Medicine, School of Medicine, Federal University of Minas Gerais, Belo Horizonte 31270-901, Brazil.
  • Silva MC; Hospital e Clínica São Roque, Ipiau 45570-000, Brazil.
  • Salomão FC; Centro Diagnóstico de Patologia, Uberlandia 38400-110, Brazil.
  • Freitas LAR; School of Medicine of Bahia, Federal University of Bahia, Salvador 40026-010, Brazil.
Diagnostics (Basel) ; 14(16)2024 Aug 19.
Article em En | MEDLINE | ID: mdl-39202292
ABSTRACT
Cholangiopathy has been described in survivors of severe COVID-19, presenting significant clinical parallels to the pre-pandemic condition of secondary sclerosing cholangitis in critically ill patients (SSC-CIP). We aimed to examine the liver histopathology of individuals with persistent cholestasis after severe COVID-19.

METHODS:

We subjected post-COVID-19 cholestasis liver samples to routine staining techniques and cytokeratin 7 immunostaining and semi-quantitatively analyzed the portal and parenchymal changes.

RESULTS:

All ten patients, five men, had a median age of 56, an interquartile range (IQR) of 51-60, and required intensive care unit and mechanical ventilation. The median and IQR liver enzyme concentrations proximal to biopsy were in IU/L ALP 645 (390-1256); GGT 925 (664-2169); ALT 100 (86-113); AST 87 (68-106); and bilirubin 4 (1-9) mg/dL. Imaging revealed intrahepatic bile duct anomalies and biliary casts. We performed biopsies at a median of 203 (150-249) days after molecular confirmation of infection. We found portal and periportal fibrosis, moderate-to-severe ductular proliferation, and bile duct dystrophy in all patients, while we observed hepatocyte biliary metaplasia in all tested cases. We observed mild-to-severe parenchymal cholestasis and bile plugs in nine and six cases. We also observed mild swelling of the arteriolar endothelial cells in five patients. We observed a thrombus in a small portal vein branch and mild periductal fibrosis in one case each. One patient developed multiple small biliary infarctions. We did not observe ductopenia in any patient.

CONCLUSIONS:

The alterations were like those observed in SSC-CIP; however, pronounced swelling of endothelial cells, necrosis of the vessel walls, and thrombosis in small vessels were notable.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Diagnostics (Basel) Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Brasil País de publicação: Suíça
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Diagnostics (Basel) Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Brasil País de publicação: Suíça