Defeat of the hepatobiliary system as the cause of death of the patient with COVID-19


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Abstract

The novel coronavirus infection COVID-19, in addition to acute respiratory syndromes, is characterized by a wide range of extrapulmonary manifestations. Damage or dysfunction of the hepatobiliary system can range from an asymptomatic increase in liver transaminases to severe liver and biliary tract damage with a fatal outcome. A clinical case of severe cholestatic lesions of the hepatobiliary system with COVID-19 in a patient without previous pathology is presented. The reasons for the development of damage to the hepatobiliary tract in this case can be considered direct damage to cholangiocytes by the SARS-CoV-2 virus, immune damage to cholangiocytes as a result of a cytokine storm, ischemic hepatitis, drug-induced hepatotoxicity of the drugs used (favipiravir, paracetamol, ceftriaxone, amoxiclav, methylprednisolone). Their combination led to changes in the bile ducts, severe cholestasis and death.

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About the authors

Elena I. Busalaeva

I.N. Ulyanov Chuvash State University; Institute of Postgraduate Medical Education of the Ministry of Healthcare of Chuvash Republic

Email: busa-elena@yandex.ru
PhD in Medicine, associate professor, associate professor of the Department of faculty and hospital therapy; associate professor of the Department of therapy and family medicine 428018, Cheboksary, 27 Mikhaila Sepselya Str

Alexey S. Abyzov

I.N. Ulyanov Chuvash State University

Email: medikchuvsu@yandex.ru
assistant at the Department of faculty and hospital therapy 428015, Cheboksary, 45 Moskovsky Avenue

Larisa V. Tarasova

I.N. Ulyanov Chuvash State University

Email: tlarisagast18@mail.ru
Dr. med. habil., associate professor, head of the Department of faculty and hospital therapy 428015, Cheboksary, 45 Moskovsky Avenue

Alexander V. Sergeev

I.N. Ulyanov Chuvash State University; Republican Bureau of Forensic Medical Examination of the Ministry of Healthcare of Chuvash Republic

Email: sergeevav@rbsme.ru
PhD in Medicine, associate professor of the Department of general and clinical morphology and forensic medicine; deputy head of medical affairs, pathologist 428018, Cheboksary, 24 Pirogova Str

Anton V. Ivanov

I.N. Ulyanov Chuvash State University; Republican Bureau of Forensic Medical Examination of the Ministry of Healthcare of Chuvash Republic

pathologist; senior lecturer at the Department of general and clinical morphology and forensic medicine 428018, Cheboksary, 24 Pirogova Str

References

  1. Metawea M.I., Yousif W.I., Moheb I. COVID 19 and liver: An A-Z literature review. Dig Liver Dis. 2021; 53(2): 146-52. doi: 10.1016/j.dld.2020.09.010.
  2. Xu Z., Shi L., Wang Y. et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med. 2020; 8(4): 420-22. https://dx.doi.org/10.1016/S2213-2600(20)30076-X.
  3. Zippi M., Fiorino S., Occhigrossi G., Hong W. Hypertransaminasemia in the course of infection with SARS-CoV-2: Incidence and pathogenetic hypothesis. World J Clin Cases. 2020; 8(8): 1385-90. https://dx.doi.org/10.12998/wjcc.v8.i8.1385.
  4. Amin M. COVID-19 and the liver: Overview. Eur J Gastroenterol Hepatol. 2021; 33(3): 309-11. https://dx.doi.org/10.1097/MEG.0000000000001808.
  5. Chai X., Hu L., Zhang Y. et al. Specific ACE2 expression in cholangiocytes may cause liver damage after 2019-nCoV infection. bioRxiv. 2020.02.03.931766. https://dx.doi.org/10.1101/2020.02.03.931766.
  6. Premkumar M., Kedarisetty C.K. Cytokine storm of COVID-19 and its impact on patients with and without chronic liver disease. J Clin Transl Hepatol. 2021; 9(2): 256-64. https://dx.doi.org/10.14218/JCTH.2021.00055.
  7. Lightsey J.M., Rockey D.C. Current concepts in ischemic hepatitis. Curr Opin Gastroenterol. 2017; 33(3): 158-63. https://dx.doi.org/10.1097/mog.0000000000000355.
  8. Yang X., Yu Y., Xu J. et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: A single centered, retrospective, observational study. Lancet Respir Med. 2020; 8(5): 475-81. https://dx.doi.org/10.1016/s2213-2600(20)30079-5.
  9. Государственный реестр лекарственных средств Минздрава России. Доступ: https://grls.rosminzdrav.ru (дата обращения - 01.09.2022).
  10. Nardo A.D., Schneeweiss-Gleixner M., Bakail M. et al. Pathophysiological mechanisms of liver injury in COVID-19. Liver Int. 2021; 41(1): 20-32. https://dx.doi.org/10.1111/liv.14730.
  11. Jothimani D., Venugopal R., Abedin M.F. et al. COVID-19 and liver. J Hepatol. 2020; 73(5): 1231-40. https://dx.doi.org/10.1016/j.jhep.2020.06.006.
  12. Тарасова Л.В., Малявин А.Г., Бусалаева Е.И. с соавт. Гипераммониемия как фактор риска неблагоприятного исхода у пациентов с новой коронавирусной инфекцией. Доказательная гастроэнтерология. 2022; 11(2): 39-43. https://dx.doi.org/10.17116/dokgastro20221102139. EDN: TCUTHJ.
  13. Яковенко Э.П., Яковенко А.В., Иванов А.Н., Агафонова Н.А. Патология пищеварительного тракта и печени при COVID-19. Экспериментальная и клиническая гастроэнтерология. 2020; 4: 19-23. https://dx.doi.org/10.31146/1682-8658-ecg-176-4-19-23. EDN: UMAJBE.
  14. Лазебник Л.Б., Голованова Е.В., Хлынова О.В. с соавт. Лекарственные поражения печени (ЛПП) у взрослых. Экспериментальная и клиническая гастроэнтерология. 2020; 2: 29-54. https://dx.doi.org/10.31146/1682-8658-ecg-174-2-29-54. EDN: RNLXSH.
  15. Лазебник Л.Б., Тарасова Л.В., Комарова Е.А. с соавт. Изменение концентрации аммиака и других биохимических показателей у пациентов с новой коронавирусной инфекцией. Экспериментальная и клиническая гастроэнтерология. 2021; 4: 76-83. https://dx.doi.org/10.31146/1682-8658-ecg-188-4-76-83. EDN: MJYLUB.
  16. Del Zompo F., De Siena M., Ianiro G. et al. Prevalence of liver injury and correlation with clinical outcomes in patients with COVID-19: Systematic review with meta-analysis. Eur Rev Med Pharmacol Sci. 2020; 24(24): 13072-88. https://dx.doi.org/10.26355/eurrev_202012_24215.
  17. Профилактика, диагностика и лечение новой коронавирусной инфекции (COVID-19): временные метод. рекомендации. Версия 9 (26.10.2020). Минздрав России. Доступ: https://static-0.minzdrav.gov.ru/system/attachments/attaches/000/052/548/original/%D0%9C%D0%A0_COVID-19_%28v.9%29.pdf?1603730062 (дата обращения - 01.09.2022). URL: https://static-0.minzdrav.gov.ru/system/attachments/attaches/000/052/548/original/%D0%9C%D0%A0_COVID-19_%28v.9%29.pdf?1603730062 (date of access - 01.09.2022) (In Russ.)].

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