Scholarlink

Background <p>Wilson’s Disease (WD) is a rare genetic disorder characterized by impaired hepatic copper elimination, potentially leading to chronic liver disease and cirrhosis. Although SARS-CoV-2 primarily affects the respiratory tract, hepatic involvement has been described. Using WD as a well-characterized model of a rare chronic liver disease with standardized long-term follow-up, we exploratively assessed short- and intermediate-term associations between SARS-CoV-2 infection and liver function as well as copper metabolism in patients with and without cirrhosis.</p> Methods <p> In this longitudinal real-world study, we analyzed 71 WD patients (49 without cirrhosis, 22 with cirrhosis) with confirmed SARS-CoV-2 infection. Laboratory parameters, 24-hour urinary copper excretion (24-UCE), and transient elastography were assessed before infection (t0), shortly after infection (t1), and &gt;12 months post-infection (t2). Effect sizes (r) were calculated for intraindividual comparisons. Clinical severity, vaccination status, and long-COVID symptoms were recorded.</p> Results <p> No patient required hospitalization. In WD patients without cirrhosis, liver enzymes, cholestasis markers, and copper metabolism remained stable across all timepoints, with predominantly very small effect sizes (|r| &lt; 0.3), indicating no clinically meaningful changes. In contrast, cirrhotic WD patients exhibited moderate to large short-term effects in transaminases and GGT (r up to 0.85) following infection. Bilirubin showed the most pronounced and persistent alteration in cirrhotic patients, with a sustained but only moderate effect (r ≈ 0.6) at long-term follow-up. Partial biochemical recovery was observed, yet normalization remained incomplete. Liver stiffness and copper parameters did not change significantly in either group.</p> Conclusions <p> SARS-CoV-2 infection was associated with persistent biochemical alterations, particularly elevated bilirubin levels of moderate magnitude in WD patients with cirrhosis, while global liver function parameters remained largely stable. These findings highlight the need for close post-infection monitoring of WD patients with cirrhosis, even in mild SARS-CoV-2 infections, to mitigate potential hepatic complications and guide ongoing management in this vulnerable population. Nevertheless, these observations are hypothesis-generating and should be interpreted cautiously due to the small, selected cirrhotic subgroup, the lack of appropriate control groups, and the delayed timing of post-infection assessments.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Exploratory longitudinal cohort study of modest bilirubin-driven biochemical liver alterations after SARS-CoV-2 infection in a selected subgroup of patients with Wilson’s disease and liver cirrhosis

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年4月20日

查看全文
  • Sebastian Köhrer,
  • Maximilian Lukas Brand,
  • Viola Leidner,
  • Holger Zimmer,
  • Andrea Langel,
  • Jessica Langel,
  • Patrick Michl,
  • Isabelle Mohr

摘要

Background

Wilson’s Disease (WD) is a rare genetic disorder characterized by impaired hepatic copper elimination, potentially leading to chronic liver disease and cirrhosis. Although SARS-CoV-2 primarily affects the respiratory tract, hepatic involvement has been described. Using WD as a well-characterized model of a rare chronic liver disease with standardized long-term follow-up, we exploratively assessed short- and intermediate-term associations between SARS-CoV-2 infection and liver function as well as copper metabolism in patients with and without cirrhosis.

Methods

In this longitudinal real-world study, we analyzed 71 WD patients (49 without cirrhosis, 22 with cirrhosis) with confirmed SARS-CoV-2 infection. Laboratory parameters, 24-hour urinary copper excretion (24-UCE), and transient elastography were assessed before infection (t0), shortly after infection (t1), and >12 months post-infection (t2). Effect sizes (r) were calculated for intraindividual comparisons. Clinical severity, vaccination status, and long-COVID symptoms were recorded.

Results

No patient required hospitalization. In WD patients without cirrhosis, liver enzymes, cholestasis markers, and copper metabolism remained stable across all timepoints, with predominantly very small effect sizes (|r| < 0.3), indicating no clinically meaningful changes. In contrast, cirrhotic WD patients exhibited moderate to large short-term effects in transaminases and GGT (r up to 0.85) following infection. Bilirubin showed the most pronounced and persistent alteration in cirrhotic patients, with a sustained but only moderate effect (r ≈ 0.6) at long-term follow-up. Partial biochemical recovery was observed, yet normalization remained incomplete. Liver stiffness and copper parameters did not change significantly in either group.

Conclusions

SARS-CoV-2 infection was associated with persistent biochemical alterations, particularly elevated bilirubin levels of moderate magnitude in WD patients with cirrhosis, while global liver function parameters remained largely stable. These findings highlight the need for close post-infection monitoring of WD patients with cirrhosis, even in mild SARS-CoV-2 infections, to mitigate potential hepatic complications and guide ongoing management in this vulnerable population. Nevertheless, these observations are hypothesis-generating and should be interpreted cautiously due to the small, selected cirrhotic subgroup, the lack of appropriate control groups, and the delayed timing of post-infection assessments.