Hunyady, Peter, Streller, Lea, Ruether, Darius F., Groba, Sara Reinartz, Bettinger, Dominik, Fitting, Daniel, Hamesch, Karim, Marquardt, Jens U., Muecke, Victoria T., Finkelmeier, Fabian, Sekandarzad, Asieb, Wengenmayer, Tobias, Bounidane, Ayoub, Weiss, Felicitas, Peiffer, Kai Henrik, Schlevogt, Bernhard, Zeuzem, Stefan, Waidmann, Oliver, Hollenbach, Marcus, Kirstein, Martha M., Kluwe, Johannes, Kuetting, Fabian and Muecke, Marcus M. . Secondary Sclerosing Cholangitis Following Coronavirus Disease 2019 (COVID-19): A Multicenter Retrospective Study. Clin. Infect. Dis.. CARY: OXFORD UNIV PRESS INC. ISSN 1537-6591

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Abstract

Background Secondary sclerosing cholangitis (SSC) is a rare disease with poor prognosis. Cases of SSC have been reported following coronavirus disease 2019 (COVID-SSC). The aim of this study was to compare COVID-SSC to SSC in critically ill patients (SSC-CIP) and to assess factors influencing transplant-free survival. Methods In this retrospective, multicenter study involving 127 patients with SSC from 9 tertiary care centers in Germany, COVID-SSC was compared to SSC-CIP and logistic regression analyses were performed investigating factors impacting transplant-free survival. Results Twenty-four patients had COVID-SSC, 77 patients SSC-CIP, and 26 patients other forms of SSC. COVID-SSC developed after a median of 91 days following COVID-19 diagnosis. All patients had received extensive intensive care treatment (median days of mechanical ventilation, 48). Patients with COVID-SSC and SSC-CIP were comparable in most of the clinical parameters and transplant-free survival was not different from other forms of SSC (P = .443, log-rank test). In the overall cohort, the use of ursodeoxycholic acid (UDCA) (odds ratio [OR], 0.36 [95% confidence interval {CI}, .16-.80], P = .013; log-rank P < .001) and high serum albumin levels (OR, 0.40 [95% CI, .17-.96], P = .040) were independently associated with an increased transplant-free survival, while the presence of liver cirrhosis (OR, 2.52 [95% CI, 1.01-6.25], P = .047) was associated with worse outcome. Multidrug-resistant organism (MDRO) colonization or infection did not impact patients' survival. Conclusions COVID-SSC and CIP-SSC share the same clinical phenotype, course of the disease, and risk factors for its development. UDCA may be a promising therapeutic option in SSC, though future prospective trials are needed to confirm our findings. We compared secondary sclerosing cholangitis (SSC) following COVID-19, with SSC in critical ill patients in a multicenter study. Both SSC entities shared the same clinical phenotype, course of disease, and risk factors for its development.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Hunyady, PeterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Streller, LeaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ruether, Darius F.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Groba, Sara ReinartzUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bettinger, DominikUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fitting, DanielUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hamesch, KarimUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Marquardt, Jens U.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Muecke, Victoria T.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Finkelmeier, FabianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sekandarzad, AsiebUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wengenmayer, TobiasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bounidane, AyoubUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Weiss, FelicitasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Peiffer, Kai HenrikUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schlevogt, BernhardUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Zeuzem, StefanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Waidmann, OliverUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hollenbach, MarcusUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kirstein, Martha M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kluwe, JohannesUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kuetting, FabianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Muecke, Marcus M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-691772
DOI: 10.1093/cid/ciac565
Journal or Publication Title: Clin. Infect. Dis.
Publisher: OXFORD UNIV PRESS INC
Place of Publication: CARY
ISSN: 1537-6591
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
CRITICALLY-ILL PATIENTS; BILE; ACIDMultiple languages
Immunology; Infectious Diseases; MicrobiologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/69177

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