Evidence map›Paper›PMID 42616061›Full record

ArticleJournal of gastroenterology2026

Clinical course, prognostic markers, and transplant implications in COVID-19-associated secondary sclerosing cholangitis.

Johannes Roman Wiessner, Matthias Kis, Daniela Lenggenhager, Caecilia Sophie Reiner, Pedro David Wendel-Garcia, Katharina Endhardt, Daniel Stocker, Nadine Stanek, Georg Leinenkugel, Anna Svarin and 10 more

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Article in Journal of gastroenterology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Johannes Roman Wiessner *Department of Gastroenterology and Hepatology, University Hospital Zurich, University of Zürich, Rämistrasse 100, CH-8091, Zurich, Switzerland.
Matthias Kis *Department of Gastroenterology and Hepatology, University Hospital Zurich, University of Zürich, Rämistrasse 100, CH-8091, Zurich, Switzerland.
Daniela LenggenhagerDepartment of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland.
Caecilia Sophie ReinerInstitute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland.
Pedro David Wendel-GarciaInstitute of Intensive Care, University Hospital Zurich, Zurich, Switzerland.
Katharina EndhardtDepartment of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland.
Daniel StockerInstitute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland.
Nadine StanekDepartment of Gastroenterology and Hepatology, Luzerner Kantonsspital, Lucerne, Switzerland.
Georg LeinenkugelDepartment of Gastroenterology and Hepatology, University Hospital Zurich, University of Zürich, Rämistrasse 100, CH-8091, Zurich, Switzerland.
Anna SvarinDepartment of Gastroenterology and Hepatology, University Hospital Zurich, University of Zürich, Rämistrasse 100, CH-8091, Zurich, Switzerland.
Simon BütikoferDepartment of Gastroenterology and Hepatology, University Hospital Zurich, University of Zürich, Rämistrasse 100, CH-8091, Zurich, Switzerland.
Bernhard MorellDepartment of Gastroenterology and Hepatology, University Hospital Zurich, University of Zürich, Rämistrasse 100, CH-8091, Zurich, Switzerland.
Philipp Karl BühlerInstitute of Intensive Care, University Hospital Zurich, Zurich, Switzerland.
Soleen GhafoorInstitute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland.
Christoph GublerDepartment of Gastroenterology and Hepatology, University Hospital Zurich, University of Zürich, Rämistrasse 100, CH-8091, Zurich, Switzerland.
Rahel HäuptleDepartment of Gastroenterology and Hepatology, Health Ostschweiz HOCH, St. Gallen, Switzerland.
David SemelaDepartment of Gastroenterology and Hepatology, Health Ostschweiz HOCH, St. Gallen, Switzerland.
Andreas Emanuel KremerDepartment of Gastroenterology and Hepatology, University Hospital Zurich, University of Zürich, Rämistrasse 100, CH-8091, Zurich, Switzerland.
Beat MüllhauptDepartment of Gastroenterology and Hepatology, University Hospital Zurich, University of Zürich, Rämistrasse 100, CH-8091, Zurich, Switzerland.
Christoph JüngstDepartment of Gastroenterology and Hepatology, University Hospital Zurich, University of Zürich, Rämistrasse 100, CH-8091, Zurich, Switzerland. juengst@gastropark.ch.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSecondary sclerosing cholangitis (SSC) has emerged as a severe complication in critically ill COVID-19 patients. This study outlines the clinical course, prognostic markers, and liver transplantation (LT) outcomes of COVID-19-associated SSC.

methodsThis retrospective multicenter study included 36 COVID-19-associated SSC patients from three Swiss tertiary centers. Clinical, laboratory, imaging, and histopathological data were analyzed with respect to outcomes defined as survival without LT versus LT or death. Post-transplant outcomes were assessed.

resultsAll 36 critically ill patients developed acute respiratory distress syndrome. SSC was diagnosed post-ICU in 80.6% of cases. After a median follow-up of 537 days, 12 patients died, six progressed to decompensation, 14 had compensated liver disease, and four underwent LT. Among 17 LT-evaluated patients, eight died during evaluation or on the waiting list. All four transplanted patients survived. Univariable analysis identified male sex and extent of elevated alkaline phosphatase (AP), bilirubin, aspartate aminotransferase, and alanine aminotransferase at SSC diagnosis, and at peak as predictors of poor outcomes. Histopathological features associated with adverse outcomes included portal edema and bile infarcts, whereas septal fibrosis, florid inflammation, and MRI-detected parenchymal signal changes correlated with transplant-free survival. In multivariable analysis, parenchymal signal changes (OR 0.03, 95%CI 0.00-0.83) and peak AP (OR 7.23, 95%CI 1.14-45.73) remained independently associated with outcome.

conclusionsCOVID-19-associated SSC carries high morbidity and mortality. Clinical, biochemical, imaging, and histopathological parameters enable early risk stratification and predict outcome. Timely LT evaluation is recommended in severe cases, given favorable post-transplant outcomes.

Indexed as

CholestasisCoronavirus disease 19Intensive care unitSclerosing cholangitis in critically ill patientsSSC

Identifiers

PMID42616061

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.