Gravidic Intrahepatic Cholestasis With Concurrent COVID-19 Infection

Makhija, Nidhi; Tayade, Surekha; Thatere, Utkarsh

doi:10.7759/cureus.29326

Cited by 2 publications

(2 citation statements)

References 9 publications

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“…Bile acid levels should be monitored throughout pregnancy due to mounting evidence that higher levels of bile acid are associated with an increased chance of adverse perinatal outcomes, such as stillbirth. (18) Intrahepatic cholestasis Pregnancies are more likely to have negative results when bile acid levels are high (19) . In our study about 15% patients had symptom like pruritus.…”

Section: Discussionmentioning

confidence: 99%

Impact of Covid-19 on the Prevalence of Intrahepatic Cholestasis of Pregnancy

Fida¹,

Wahab²,

Naz³

et al. 2023

PJMHS

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Background: The virulent pathogen SARS-CoV-2 first appeared in the Chinese province of Hubei in December 2019. Pregnant women were a high-risk population in the pandemic because immune system alterations that occur during pregnancy make them more vulnerable to foreign infections. Late-pregnancy cholestasis is a dangerous liver condition that can cause the foetus to experience potentially fatal problems like early birth and stillbirth. In the present study we were testing the Bile acid level during pregnancy patients after covid pandemic. Objectives: To evaluate the prevalence of intrahepatic cholestasis in pregnant patients after Covid -19 pandemic. Materials and Methods: This cross-sectional study was conducted at department of Dr.fida painless and General Hospital Peshawar from jan 2022 to Dec 2022. We enrolled 186 pregnant patients after fulfilling the inclusion criteria. 5 ml blood sample were also taken from the patients. Serum was extracted and Bile acid test were performed in clinical laboratory. Data were collected in predesign questionnaire. Results: Total 186 patients were enrolled in the study with mean age of 37.18±6.39 years (Range 18-45 years). The mean value of all enrolled patients was 31.38±5.79 with minimum and maximum value of bile acids 20 micromol/L and 40.6.00 micromol/L. In our study 95 (56.5%) of patients belongs to 36 to 45 years of age group followed by age group of 26 to 35 years in which 60 (35.7%) patients and 13 (7.7%) patients were belongs to age group of 18 to 25 years. Practical implication: This study will help the clinical practitioner to take care of pregnant patients in order to avoid the prevalence of intrahepatic cholestasis. Conclusion: It is concluded from this research study that prevalence of intrahepatic cholestasis in pregnancy has increased after Covid-19 pandemic. Keywords: COVID-19, cholestasis, pregnancy, elevated Liver Enzyme, Bile Acids.

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Section: Discussionmentioning

confidence: 99%

Impact of Covid-19 on the Prevalence of Intrahepatic Cholestasis of Pregnancy

Fida¹,

Wahab²,

Naz³

et al. 2023

PJMHS

View full text Add to dashboard Cite

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“…Regarding pregnancy, elevated liver enzymes have been reported in patients with COVID infection and intrahepatic cholestasis of pregnancy (ICP) compared to non-infected women [17]. As some authors have hypothesized a possible correlationcausation sequence between maternal COVID-19 and ICP [18], the objective of this study was to assess the incidence and course of ICP before and during the pandemic era.…”

Section: Introductionmentioning

confidence: 98%

Intrahepatic Cholestasis of Pregnancy during COVID-19 Pandemic

Malarkiewicz,

Nowacka,

Januszaniec

et al. 2024

Medicina

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Background and Objectives: Intrahepatic cholestasis of pregnancy (ICP) stands as one of the most prevalent concerns in maternal–fetal medicine, presenting a significant risk to fetal health and often associated with liver dysfunction. Concurrently, the coronavirus-19 (COVID-19) infection can lead to hepatic cell injury through both direct and indirect pathways. Hypothetically, these two conditions may coincide, influencing each other. This study aimed to comparatively assess the incidence and severity of ICP before and during the COVID-19 pandemic. Methods: A retrospective cohort study was conducted, comparing the incidence and severity of ICP between January 2018 and February 2020 (pre-COVID-19 period) and March 2020 to March 2022 (COVID-19 period) across two hospitals, encompassing 7799 deliveries. The diagnosis of ICP was established using the ICD-10 code and defined as total bile acids (BA) levels ≥ 10 μmol/L. Statistical analysis included descriptive statistics, Chi-square and Mann–Whitney U tests, as well as multiple or logistic regression analysis. Results: A total of 226 cases of ICP were identified. The incidence of mild cholestasis (BA < 40 μmol/L) was lower during the pandemic compared to before (3% before versus 2%, p < 0.05), while the incidence of moderate and severe ICP remained unchanged (0.6% before vs. 0.4%, p = 0.2). Overall, the total incidence of ICP was lower during the pandemic (3.6% before versus 2.4%, p = 0.01). No significant differences were observed in severity (as defined by BA and liver function test levels), rates of caesarean section, or neonatal birth weights. Conclusions: During the COVID-19 pandemic, the total incidence of ICP appeared to be lower. However, this reduction was primarily observed in cases of mild ICP, potentially indicating challenges in detection or reduced access to medical services during this period. The incidence of moderate and severe ICP remained unchanged, suggesting that these forms of the condition were unaffected by the pandemic’s circumstances.

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Gravidic Intrahepatic Cholestasis With Concurrent COVID-19 Infection

Cited by 2 publications

References 9 publications

Impact of Covid-19 on the Prevalence of Intrahepatic Cholestasis of Pregnancy

Impact of Covid-19 on the Prevalence of Intrahepatic Cholestasis of Pregnancy

Intrahepatic Cholestasis of Pregnancy during COVID-19 Pandemic

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