Systematic Reviews
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Methodol. Sep 20, 2023; 13(4): 296-322
Published online Sep 20, 2023. doi: 10.5662/wjm.v13.i4.296
Post-COVID-19 cholangiopathy: Systematic review
Mazen Abdalla Rasheed, Vinícius Remus Ballotin, Lucas Goldmann Bigarella, Jonathan Soldera
Mazen Abdalla Rasheed, Jonathan Soldera, Acute Medicine, University of South Wales, Cardiff CF37 1DL, United Kingdom
Vinícius Remus Ballotin, Lucas Goldmann Bigarella, School of Medicine, Universidade de Caxias do Sul, Caxias do Sul 95070-560, Brazil
Author contributions: All authors contributed to the study concept and design, drafting of the manuscript, data acquisition, analysis and interpretation, and critical revision of the manuscript for important intellectual content.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
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: Jonathan Soldera, MD, MSc, Tutor, Acute Medicine, University of South Wales, 86-88 Adam St, Cardiff CF37 1DL, United Kingdom. jonathansoldera@gmail.com
Received: April 15, 2023
Peer-review started: April 15, 2023
First decision: May 12, 2023
Revised: June 7, 2023
Accepted: August 23, 2023
Article in press: August 23, 2023
Published online: September 20, 2023
Processing time: 157 Days and 12.8 Hours
Abstract
BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic has had a profound impact on global health, primarily characterized by severe respiratory illness. However, emerging evidence suggests that COVID-19 can also lead to secondary sclerosing cholangitis (SC), referred to as post-COVID-19 cholangiopathy.

AIM

To synthesize currently reported cases to assess the current state of knowledge on post-COVID-19 cholangiopathy.

METHODS

Medical Subject Headings and Health Sciences Descriptors were used to retrieve relevant studies, which were combined using Boolean operators. Searches were conducted on electronic databases including Scopus, Web of Science, and MEDLINE (PubMed). Studies published in English, Spanish, or Portuguese were included, with no restrictions on the publication date. Additionally, the reference lists of retrieved studies were manually searched. Simple descriptive analyses were used to summarize the results. Then the data were extracted and assessed based on Reference Citation Analysis (https://www.referencecitationanalysis.com/).

RESULTS

The initial search yielded a total of 192 articles. After screening, 85 articles were excluded due to duplication, leaving 107 articles for further review. Of these, 63 full-length articles met the inclusion criteria and were included in the analyses. Most of the patients were male and exhibited elevated liver function tests (93.8%). Magnetic resonance imaging revealed duct thickening with contrast enhancement (47.7%), as well as beading of the intrahepatic ducts (45.7%) with peribiliary contrast enhancement on diffusion (28.7%). Liver biopsy results confirmed SC in most cases (74.4%). Sixteen patients underwent liver transplantation, with three experiencing successful outcomes.

CONCLUSION

Post-COVID-19 cholangiopathy is a serious condition that is expected to become increasingly concerning in the coming years, particularly considering long COVID syndromes. Although liver transplantation has been proposed as a potential treatment option, more research is necessary to establish its efficacy and explore other potential treatments.

Keywords: Coronavirus disease 2019; Severe acute respiratory syndrome coronavirus 2; Cholangiopathy; Liver function tests; Liver transplantation

Core Tip: Post-coronavirus disease 2019 (COVID-19) cholangiopathy is a rare but serious complication that can occur after contracting COVID-19. It is characterized by inflammation and damage to the bile ducts. To better understand this condition and its treatment, we conducted a systematic review of post-COVID-19 cholangiopathy cases. Sixty-three articles met the inclusion criteria, representing 540 patients. Males over 50-years-old were more prone to this condition, which is often accompanied by elevated liver function, bile duct thickening, and kidney failure after prolonged use of mechanical ventilation. Further research is needed to confirm the effectiveness of liver transplantation in treating post-COVID-19 cholangiopathy.