Defeat of the hepatobiliary system as the cause of death of the patient with COVID-19


DOI: https://dx.doi.org/10.18565/therapy.2022.7.85-90

Busalaeva E.I., Abyzov A.S., Tarasova L.V., Sergeev A.V., Ivanov A.V.

1) I.N. Ulyanov Chuvash State University, Cheboksary; 2) Institute of Postgraduate Medical Education of the Ministry of Healthcare of Chuvash Republic, Cheboksary; 3) Republican Bureau of Forensic Medical Examination of the Ministry of Healthcare of Chuvash Republic, Cheboksary
Abstract. The novel coronavirus infection COVID-19, in addition to acute respiratory syndromes, is characterized by a wide range of extrapulmonary manifestations. Damage or dysfunction of the hepatobiliary system can range from an asymptomatic increase in liver transaminases to severe liver and biliary tract damage with a fatal outcome. A clinical case of severe cholestatic lesions of the hepatobiliary system with COVID-19 in a patient without previous pathology is presented. The reasons for the development of damage to the hepatobiliary tract in this case can be considered direct damage to cholangiocytes by the SARS-CoV-2 virus, immune damage to cholangiocytes as a result of a cytokine storm, ischemic hepatitis, drug-induced hepatotoxicity of the drugs used (favipiravir, paracetamol, ceftriaxone, amoxiclav, methylprednisolone). Their combination led to changes in the bile ducts, severe cholestasis and death.
Keywords: COVID-19, liver, cholestasis, biliary tract, clinical case, damage
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About the Autors

Elena I. Busalaeva, PhD in Medicine, associate professor, associate professor of the Department of faculty and hospital therapy, I.N. Ulyanov Chuvash State University, associate professor of the Department of therapy and family medicine, Institute of Postgraduate Medical Education of the Ministry of Healthcare of Chuvash Republic. Address: 428018, Cheboksary, 27 Mikhaila Sepselya Str. E-mail: busa-elena@yandex.ru. ORCID: https://orcid.org/0000-0001-7313-0365. Scopus Author ID: 56657473200
Alexey S. Abyzov, assistant at the Department of faculty and hospital therapy, I.N. Ulyanov Chuvash State University. Address: 428015, Cheboksary, 45 Moskovsky Avenue. E-mail: medikchuvsu@yandex.ru. ORCID: https://orcid.org/0000-0002-3770-9414
Larisa V. Tarasova, Dr. med. habil., associate professor, head of the Department of faculty and hospital therapy,
I.N. Ulyanov Chuvash State University. Address: 428015, Cheboksary, 45 Moskovsky Avenue.
E-mail: tlarisagast18@mail.ru. ORCID: https://orcid.org/0000-0003-1496-0689. Scopus Author ID: 35777248600
Alexander V. Sergeev, PhD in Medicine, associate professor of the Department of general and clinical morphology and forensic medicine, I.N. Ulyanov Chuvash State University, deputy head of medical affairs, pathologist at Republican Bureau of Forensic Medical Examination of the Ministry of Healthcare of Chuvash Republic. Address: 428018, Cheboksary, 24 Pirogova Str. E-mail: sergeevav@rbsme.ru. ORCID: https://orcid.org/0000-0002-8230-8927
Anton V. Ivanov, pathologist at Republican Bureau of Forensic Medical Examination of the Ministry of Healthcare of Chuvash Republic, senior lecturer at the Department of general and clinical morphology and forensic medicine,
I.N. Ulyanov Chuvash State University. Address: 428018, Cheboksary, 24 Pirogova Str. SPIN-код: 8755-4778. AuthorID: 987965


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