Published online May 27, 2023. doi: 10.4240/wjgs.v15.i5.788
Peer-review started: November 23, 2022
First decision: January 2, 2023
Revised: February 10, 2023
Accepted: April 7, 2023
Article in press: April 7, 2023
Published online: May 27, 2023
Processing time: 183 Days and 14.7 Hours
Post-coronavirus disease 2019 (COVID-19) cholangiopathy (PCC) is a rare but life-threatening complication of COVID-19 infection. PCC typically presents when patients recovering from the contagion and manifests as cholestasis in patients with no history of pre-existing liver disease. The pathogenesis of PCC is little understood. Hepatic injury in PCC could be mediated by the predilection of severe acute respiratory syndrome coronavirus 2 for cholangiocytes. Though PCC shows some resemblance to secondary sclerosing cholangitis in critically ill patients, it is considered as a separate and unique entity in the literature. Various treatment options like ursodeoxycholic acid, steroids, plasmapheresis, and endoscopic retrograde cholangiopancreatography guided interventions have been tried but with limited success. We have noticed significant improvement in liver function with antiplatelet therapy in a couple of patients. PCC can progress to end-stage liver disease necessitating liver transplantation. In this article, we discuss the current knowledge of PCC focusing on its pathophysiology, clinical manifestations, and management strategies.
Core Tip: Post-coronavirus disease 2019 (COVID-19) cholangiopathy (PCC) is a rare complication of COVID-19 infection with gruesome prognosis. There is no proven treatment for this entity and patients often end up in liver transplantation. This review focusses on pathophysiology, clinical manifestations and management strategies of PCC along with our experience with antiplatelets in managing patients with PCC.