■冠状病毒病-2019(COVID-19)胆管病是最近已知的实体。肝移植治疗COVID-19诱导的胆管病变的报道很少。众所周知,疫苗可以预防严重疾病并改善预后。然而,目前尚无关于COVID-19疫苗对胆汁淤积的影响的报道。因此,我们旨在比较接种疫苗和未接种疫苗的人群中发生COVID-19感染后发生胆汁淤积的患者的病程和结局.方法:在排除其他胆汁淤积原因后,将在大流行期间诊断为COVID后胆汁淤积的患者纳入研究。
8名未接种疫苗和7名接种疫苗的个体在COVID-19感染后出现胆汁淤积。基线人口统计,介绍,严重程度,两组的COVID-19管理相似。然而,未接种疫苗组的患者病程延长.在接种组中,ALP峰值为312(239-517)U/L,在未接种组中为571.5(368-1058)U/L(P=0.02)。同样,接种疫苗组的γ-谷氨酰转肽酶(GGT)峰值(325[237-600]U/L)低于未接种疫苗组(832[491-1640]U/L;P=0.004).然而,总胆红素的峰值,转氨酶,两组的INR和INR相似。未接种疫苗组有5例患者逐渐出现腹水,而接种疫苗组无一例出现腹水。对五名患者进行了血浆置换,在未接种疫苗的组中,有2例成功连接到活体肝移植。在未接种疫苗的组中,只有两名患者通过保守治疗康复,而接种组通过保守治疗全部康复。未接种疫苗组的其他四名患者计划进行肝移植。
■COVID-19后胆汁淤积与高发病率和高死亡率相关,值得早期识别和适当的管理。疫苗接种可以改变严重COVID-19感染的过程并改善预后。
UNASSIGNED: Coronavirus disease-2019 (COVID-19) cholangiopathy is a recently known entity. There are very few
reports of liver transplantation for COVID-19 induced cholangiopathy. It is well-known that vaccines can prevent severe disease and improve outcomes. However, there are no
reports on the impact of COVID-19 vaccines on cholestasis. Therefore, we aimed to compare the course and outcome of patients who developed cholestasis following COVID-19 infection among vaccinated and unvaccinated individuals. Methods: Patients diagnosed with post-COVID cholestasis during the pandemic were included in the study after excluding other causes of cholestasis.
UNASSIGNED: Eight unvaccinated and seven vaccinated individuals developed cholestasis following COVID-19 infection. Baseline demographics, presentation, severity, and management of COVID-19 were similar in both groups. However, patients in the unvaccinated group had a protracted course. The peak ALP was 312 (239 - 517) U/L in vaccinated group and 571.5 (368-1058) U/L in unvaccinated group (P = 0.02). Similarly, the peak γ-glutamyl transpeptidase (GGT) values were lower in vaccinated (325 [237-600] U/L) than in unvaccinated group (832 [491-1640] U/L; P = 0.004). However, the peak values of total bilirubin, transminases, and INR were similar in both groups. Five patients developed ascites gradually in unvaccinated group while none in vaccinated group developed ascites. Plasma exchange was done in five patients, and two were successfully bridged to living donor liver transplantation in unvaccinated group. Only two patients recovered with conservative management in the unvaccinated group, while all recovered with conservative management in the vaccinated group. The other four patients in unvaccinated group were planned for liver transplantation.
UNASSIGNED: Post-COVID-19 cholestasis is associated with high morbidity and mortality, meriting early identification and appropriate management. Vaccination can modify the course of severe COVID-19 infection and improve outcomes.