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Review
. 2023 Oct 4:15:151-164.
doi: 10.2147/HMER.S385133. eCollection 2023.

Clinical and Histopathological Discoveries in Patients with Hepatic Injury and Cholangiopathy Who Have Died of COVID-19: Insights and Opportunities for Intervention

Joseph K Lim  1 , Basile Njei  1
Affiliations
Review

Clinical and Histopathological Discoveries in Patients with Hepatic Injury and Cholangiopathy Who Have Died of COVID-19: Insights and Opportunities for Intervention

Joseph K Lim et al. Hepat Med. .

Abstract

The COVID-19 pandemic has had a profound impact on global health, necessitating a comprehensive understanding of its diverse manifestations. Cholangiopathy, a condition characterized by biliary dysfunction, has emerged as a significant complication in COVID-19 patients. In this review, we report the epidemiology of COVID-19, describe the hepatotropism of SARS-CoV-2, and present the histopathology of acute liver injury (ALI) in COVID-19. Additionally, we explore the relationship between pre-existing chronic liver disease and COVID-19, shedding light on the increased susceptibility of these individuals to develop cholangiopathy. Through an in-depth analysis of cholangiopathy in COVID-19 patients, we elucidate its clinical manifestations, diagnostic criteria, and underlying pathogenesis involving inflammation, immune dysregulation, and vascular changes. Furthermore, we provide a summary of studies investigating post-COVID-19 cholangiopathy, highlighting the long-term effects and potential management strategies for this condition, and discussing opportunities for intervention, including therapeutic targets, diagnostic advancements, supportive care, and future research needs.

Keywords: COVID-19; cholangiopathy; histopathology; interventions; long-COVID-19.

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Conflict of interest statement

Dr Joseph K Lim reports grants from Intercept, Viking, Novo Nordisk, Gilead, Pfizer, and Inventiva, outside the submitted work. The authors report no other conflicts of interest in this work.

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Grants and funding

The authors declare that there was no specific funding received for the research, authorship, or publication of this manuscript.