J Intern Med
. 2021 Mar 30.
doi: 10.1111/joim.13292. Online ahead of print.
Cholestatic liver injury in COVID-19 is a rare and distinct entity and is associated with increased mortality
Ben L Da 1 , Kelly Suchman 2 , Nitzan Roth 1 , Anam Rizvi 3 , Maria Vincent 4 , Arvind J Trindade 2 , David Bernstein 1 , Sanjaya K Satapathy 1 , Northwell COVID-19 Research Consortium
Affiliations
- PMID: 33786906
- DOI: 10.1111/joim.13292
Abstract
Current evidence indicates that the development of acute hepatocellular liver injury during coronavirus disease 2019 (COVID-19) is associated with more severe COVID-19 disease.[1] Since SARS-CoV2 is able to enter the liver via the ACE2 receptor proteins located on the epithelium of bile ducts, direct viral cholangiocyte injury is theoretically a possible pathogenic mechanism of the virus resulting in cholestatic liver injury.[2] Supporting this idea: a recent meta-analysis that reported serum alkaline phosphatase (ALP) elevations occurs in up to 13.7% of patients[3], a case series describing the clinical/histologic features of three patients with COVID-19 cholangiopathy[4], and a recent study reporting higher fatality rates in COVID-19 patients with cholestasis.[5].
Keywords: Alkaline Phosphatase; COVID-19; Cholestasis; Mortality; SARS-CoV2.