A case series, described in Intensive Care Medicine, reports on four critically ill COVID-19 patients who developed a complication similar to secondary sclerosing cholangitis, early in the COVID-19 pandemic.

The four men, 48 to 68 years of age, required prolonged mechanical ventilation, renal support, and veno-venous extracorporeal membrane oxygenation (VV-ECMO) during the first 3 months of the pandemic in Belgium. Investigators stated that in 3 months, four COVID-19 patients in a cohort of 114 patients indicates that 5.4% of mechanically ventilated COVID patients and 30.7% of VV-ECMO-treated COVID patients developed the condition. They compared the situation to influenza patients and stated that over a 28-month period from April 2018 to 2020, in their ICU, there was a 7% incidence of secondary sclerosing cholangitis in critically ill patients (SSC-CIP) in VV-ECMO-treated influenza patients.

Two patients in the case series needed liver transplants on account of refractory cholangitis. One of the transplant patients is fine while the other died due to septic shock. Another patient died following hepatic hemorrhage. The fourth patient had mild SSC-CIP and had a better outcome… (Medpage Today)