World Journal of Medical Case Reports

Submit a Manuscript

Publishing with us to make your research visible to the widest possible audience.

Propose a Special Issue

Building a community of authors and readers to discuss the latest research and develop new ideas.

The Trajectories of Hepato-Biliary Indices Following Exposure to SARS-CoV-2

Background: The impact of SARS-CoV-2 on the hepato-biliary system is conflicting within the existing literature. Previous studies on the subject have mostly been documented among Caucasians using retrospectively-acquired data from patients with several confounding variables. Hence, the current study evaluated the trajectories of hepato-biliary biochemical indices among SARS-CoV-2-infected Nigerians who had no background confounding factors. Methods: This was a prospectively-designed longitudinal study conducted within Southern Nigeria among patients with RT-PCR-confirmed mild SARS-CoV-2 infection. All eligible participants were serially monitored/followed up before, during, and after mild SARS-CoV-2 infection using clinical/laboratory parameters to determine the impact of the virus on the hepato-biliary system. Specimen acquisition, laboratory workflow, and data management were all carried out using standardized protocols. Results: Among 152 studied, 46.1% had mild SARS-CoV-2 infection 5–10 days (Mean=7.5; SD:=2.19) after exposure with male predominance. Cough, malaise, and loss of taste/smell were the most predominant clinical manifestations among the confirmed mild cases. During the follow-up period, an increasing trend of hepato-biliary indices of the cholestatic pattern (with only total bilirubin and GGT reaching statistically significant threshold) in parallel with inflammatory markers (CRP, di-dimer and the neutrophil to lymphocyte ratio) was observed between 2-12 days following mild SARS-CoV-2 infection. However, no relationship was established between these cholestatic and inflammatory markers among the mild SARS-CoV-2-infected patients (p>0.05). Conclusion: Mild SARS-CoV-2 infection is associated with altered hepato-biliary biochemical indices of cholestatic pattern independent of SARS-CoV-2-induced inflammatory events. Incorporating hepato-biliary assessment during the initial evaluation and the use of non-hepatotoxic therapeutics during treatment is highly recommended.

SARS-CoV-2, COVID-19, Hepato-Biliary Indices, Inflammatory Markers

APA Style

Kelachi Thankgod Wala, Collins Amadi, Stephenson Lawson, Emmanuel Mustapha Owamagbe, Nkeiruka Joyce Amadi. (2023). The Trajectories of Hepato-Biliary Indices Following Exposure to SARS-CoV-2. World Journal of Medical Case Reports, 4(1), 14-21. https://doi.org/10.11648/j.wjmcr.20230401.13

ACS Style

Kelachi Thankgod Wala; Collins Amadi; Stephenson Lawson; Emmanuel Mustapha Owamagbe; Nkeiruka Joyce Amadi. The Trajectories of Hepato-Biliary Indices Following Exposure to SARS-CoV-2. World J. Med. Case Rep. 2023, 4(1), 14-21. doi: 10.11648/j.wjmcr.20230401.13

AMA Style

Kelachi Thankgod Wala, Collins Amadi, Stephenson Lawson, Emmanuel Mustapha Owamagbe, Nkeiruka Joyce Amadi. The Trajectories of Hepato-Biliary Indices Following Exposure to SARS-CoV-2. World J Med Case Rep. 2023;4(1):14-21. doi: 10.11648/j.wjmcr.20230401.13

Copyright © 2023 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

1. Osuchowski MF, Winkler MS, Skirecki T, Cajander S, Shankar-Hari M, Lachmann G, et al. The COVID-19 puzzle: deciphering pathophysiology and phenotypes of a new disease entity. Lancet Respir Med. 2021; 9 (6): 622-42.
2. Gavriatopoulou M, Korompoki E, Fotiou D, Ntanasis-Stathopoulos I, Psaltopoulou T, Kastritis E, et al. Organ-specific manifestations of COVID-19 infection. Clin Exp Med. 2020; 20 (4): 493-506.
3. Beyerstedt S, Casaro EB, Rangel ÉB. COVID-19: angiotensin-converting enzyme 2 (ACE2) expression and tissue susceptibility to SARS-CoV-2 infection. Eur J Clin Microbiol Infect Dis. 2021; 40 (5): 905-9.
4. Cai Q, Huang D, Yu H, Zhu Z, Xia Z, Su Y, et al. COVID-19: Abnormal liver function tests. J Hepatol. 2020; 73 (3): 566–7.
5. Xie H, Zhao J, Lian N, Lin S, Xie Q, Zhuo H. Clinical characteristics of non-ICU hospitalized patients with coronavirus disease 2019 and liver injury: A retrospective study. Liver Int. 2020; 40 (6): 1321-6.
6. Wang Y, Liu S, Liu H, Li W, Lin F, Jiang L, et al. SARS-CoV-2 infection of the liver directly contributes to hepatic impairment in patients with COVID-19. J Hepatol. 2020; 73 (4): 807-816.
7. Zhang H, Liao YS, Gong J, Liu J, Zhang H. Clinical characteristics and risk factors for liver injury in COVID-19 patients in Wuhan. World J Gastroenterol. 2020; 26 (31): 4694-702.
8. Wang Q, Zhao H, Liu LG, Wang YB, Zhang T, Li MH, et al. Pattern of liver injury in adult patients with COVID-19: a retrospective analysis of 105 patients. Mil Med Res. 2020; 7 (1): 28. doi: 10.1186/s40779-020-00256-6.
9. Da BL, Mitchell RA, Lee BT, Perumalswami P, Im GY, Agarwal R, et al. Kinetic patterns of liver enzyme elevation with COVID-19 in the USA. Eur J Gastroenterol Hepatol. 2020; 32 (11): 1466-9.
10. Ali N, Hossain K. Liver injury in severe COVID-19 infection: current insights and challenges. Expert Rev Gastroenterol Hepatol. 2020; 14 (10): 879-84.
11. Lin H, Wu LJ, Guo SQ, Chen RL, Fan JR, Ke B, Pan ZQ. Dynamic monitoring of serum liver function indexes in patients with COVID-19. World J Clin Cases. 2021; 9 (7): 1554-1562.
12. Kasapoglu B, Yozgat A, Tanoglu A, Can G, Sakin YS, Kekilli M. Gamma-glutamyl-transferase may predict COVID-19 outcomes in hospitalized patients. Int J Clin Pract. 2021; 75 (12): e14933. DOI: 10.1111/ijcp.14933.
13. Lawson S, Amadi C. Potentials of varied inflammatory indices in the prediction of COVID-19 severity among Nigerians. Adv Biochem. 2022; 10 (1): 18-24.
14. Lawson S, Amadi C. Assessment of surrogate markers/Indices of systemic inflammation Among COVID-19 patients with and without comorbid conditions. Am J Lab Med. 2022; 1 (7): 16-22.
15. Amadi C, Lawson S. Impact of systemic inflammation on sex-based bias during SARS-CoV-2 infection among Nigerians. Eur J Clin Biomed Sci. 2022; 8 (1); 1-8.
16. AmadI C, Lawson S, Amadi B, Agbo E. Correlation of plasma albumin status with markers of hepato-biliary dysfunction and systemic inflammation among COVID-19 patients. Biomed Sci. 2022; 8 (1): 41-48.
17. Amadi C, Lawson S, Nyeche JI, Boniface I, Kelachi WT, Owamagbe EM, et al. Patterns of Hepatobiliary Pathologies and Their Relationship with Markers of Inflammation in COVID-19 Patients. Eur J Clin Med. 2023; 4 (1): 7-13.
18. Nas SF, Ali M, Azu LM, Abdallah MS, Yusuf SF. Epidemiology of novel COVID-19 in Nigeria. Microb Infect Dis 2020; 1 (2): 49-56. DOI: 10.21608/mid.2020.10353.
19. Nigerian Centre for Disease Control (NCDC). Guidelines and protocols on prevention of COVID-19. Available from: https://covid19.ncdc.gov.ng/guidelines.php. Accessed July 24, 2022.
20. Kwok KO, Huang Y, Tsoi MT, Tang A, Wong SY, Wei WI, et al. Epidemiology, clinical spectrum, viral kinetics and impact of COVID-19 in the Asia-Pacific region. Respirology. 2021; 26 (4): 322-33.
21. Zeng QL, Yu ZJ, Ji F, Li GM, Zhang GF, Xu JH, et al. Dynamic changes in liver function parameters in patients with coronavirus disease 2019: a multicentre, retrospective study. BMC Infectious Diseases. 2021; 21 (1): 1-5.
22. Tian D, Ye Q. Hepatic complications of COVID-19 and its treatment. J Med Virol 2020; 92: 1818-24.
23. Xu L, Liu J, Lu M, Yang D, Zheng X. Liver injury during highly pathogenic human coronavirus infections. Liver Inter. 2020; 40 (5): 998-1004.
24. Przekop D, Gruszewska E, Chrostek L. Liver function in COVID-19 infection. World J Hepatol 2021; 13 (12): 1909-18.
25. Quintero-Marzola ID, Fontalvo-Mendoza MF, Cárdenas-Gómez JC, Quintana-Pájaro LJ, Ramos-Villegas Y, Manzur-Jattin F, et al. Liver and SARS-CoV-2: Literature key aspects. Rev Colomb Gastroenterol. 2021; 36 (4): 485-93.