{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T14:01:20Z","timestamp":1787666480801,"version":"build-2736575974"},"reference-count":47,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2022,6,18]],"date-time":"2022-06-18T00:00:00Z","timestamp":1655510400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatology"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Cholestasis is associated with disease severity and worse outcome in COVID\u201019. Cases of secondary sclerosing cholangitis (SSC) after severe acute respiratory syndrome coronavirus 2 (SARS\u2010CoV\u20102) infection have been described.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Approach and Results<\/jats:title>\n                    <jats:p>\n                      Hospitalized patients with COVID\u201019 between 03\/2020 and 07\/2021 were included. Patients were stratified as having (i) no chronic liver disease (CLD), (ii) non\u2010advanced CLD (non\u2010ACLD), or (iii) advanced CLD (ACLD). Patients with CLD and non\u2013COVID\u201019 pneumonia were matched to patients with CLD and COVID\u201019 as a control cohort. Liver chemistries before (Pre) and at first, second, and third blood withdrawal after SARS\u2010CoV\u20102 infection (T1\u2013T3) and at last available time point (last) were recorded. A total of 496 patients were included. In total, 13.1% (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u00a0=\u200965) had CLD (non\u2010ACLD: 70.8%; ACLD: 29.2%); the predominant etiology was NAFLD\/NASH (60.0%). COVID\u201019\u2013related liver injury was more common among patients with CLD (24.6% vs. 10.6%;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u00a0=\u20090.001). After SARS\u2010CoV\u20102 infection, patients with CLD exhibited progressive cholestasis with persistently increasing levels of alkaline phosphatase (Pre: 91.0 vs. T1: 121.0 vs. last: 175.0\u2009U\/L;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u00a0&lt;\u20090.001) and gamma\u2010glutamyl transferase (Pre: 95.0 vs. T1: 135.0 vs. last: 202.0\u2009U\/L;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u00a0=\u20090.001). A total of 23.1% of patients with CLD (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u00a0=\u200915\/65) developed cholestatic liver failure (cholestasis plus bilirubin \u22656\u2009mg\/dl) during COVID\u201019, and 15.4% of patients (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u00a0=\u200910\/65) developed SSC. SSC was significantly more frequent among patients with CLD and COVID\u201019 than in patients with CLD and non\u2013COVID\u201019 pneumonia (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u00a0=\u20090.040). COVID\u201019\u2013associated SSC occurred predominantly in patients with NAFLD\/NASH and metabolic risk factors. A total of 26.3% (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u00a0=\u20095\/19) of patients with ACLD experienced hepatic decompensation after SARS\u2010CoV\u20102 infection.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>About 20% of patients with CLD develop progressive cholestasis after SARS\u2010CoV\u20102 infection. Patients with NAFLD\/NASH and metabolic risk factors are at particular risk for developing cholestatic liver failure and\/or SSC after COVID\u201019.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hep.32582","type":"journal-article","created":{"date-parts":[[2022,5,21]],"date-time":"2022-05-21T11:14:37Z","timestamp":1653131677000},"page":"1563-1575","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":71,"title":["Progressive cholestasis and associated sclerosing cholangitis are frequent complications of COVID\u201019 in patients with chronic liver disease"],"prefix":"10.1097","volume":"76","author":[{"given":"Lukas","family":"Hartl","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Medicine III,Medical University of Vienna,Vienna,Austria"},{"name":"Vienna Hepatic Hemodynamic Lab,Division of Gastroenterology and Hepatology,Department of Medicine III,Medical 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Vienna,Vienna,Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0411-166X","authenticated-orcid":false,"given":"Georg","family":"Semmler","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Medicine III,Medical University of Vienna,Vienna,Austria"},{"name":"Vienna Hepatic Hemodynamic Lab,Division of Gastroenterology and Hepatology,Department of Medicine III,Medical University of Vienna,Vienna,Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathias","family":"Schneeweiss\u2010Gleixner","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Medicine III,Medical University of 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Vienna,Vienna,Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Lampichler","sequence":"additional","affiliation":[{"name":"Department of Biomedical Imaging and Image\u2010Guided Therapy,Medical University of Vienna,Vienna,Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emina","family":"Halilbasic","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Medicine III,Medical University of Vienna,Vienna,Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert Friedrich","family":"St\u00e4ttermayer","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Medicine III,Medical University of Vienna,Vienna,Austria"},{"name":"Vienna Hepatic Hemodynamic Lab,Division of Gastroenterology and Hepatology,Department of Medicine III,Medical University of 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