Ischaemic Sclerosing Cholangitis Post COVID-19: A Case Report

Coronavirus disease 2019 (COVID-19) primarily presents with respiratory symptoms. However, it is increasingly recognized as a multisystem condition involving extra-pulmonary complications, including hepatic involvement. Objective: We report a case of hepatic injury in the form of ischemic sclerosing cholangitis secondary to SARS-CoV-2 infection. Case report: A 71-year-old female patient was admitted to the intensive care unit for two months due to COVID-19 viral pneumonia complicated by acute respiratory distress. During the course of her hospitalization, she developed abnormal liver tests suggestive of cholestasis. A diagnosis of post-COVID-19 ischemic cholangitis was established. She was treated with ursodeoxycholic acid combined with bezafibrate. The clinical course was unfavorable, marked by the development of secondary cirrhosis complicated by edema-ascites decompensation. Given her age, liver transplantation was not considered. Conclusion: Post-COVID-19 ischemic cholangitis is a rare but serious complication. It should be considered in the presence of persistent cholestasis following severe COVID-19 pneumonia.