Infection by the SARS-COV-2 coronavirus causes mainly respiratory symptoms. However, it is also known to cause systemic involvement. Liver enzyme abnormalities have been reported in over half of hospitalised patients.1

Since the start of the pandemic, there have been several reported cases of patients developing secondary sclerosing cholangitis or post-COVID-19 cholangiopathy. This is a new condition which seems to be caused by factors already described in secondary sclerosing cholangitis in critically ill patients (SSC-CIP), but to which is also added the potential direct damage produced by SARS-COV-2 in the biliary epithelium. It is known that the virus can enter cells through the angiotensin-COnverting enzyme 2 (ACE2) receptor, a receptor expressed in different cells of the human body, including cholangiocytes, so it is possible that there is a direct interaction between SARS-COV-2 and the biliary epithelium.2

The aim of this study was to analyse the development of cholangiopathy and subsequent sclerosing cholangitis in patients who required admission to the Intensive Care Unit (ICU) due to SARS-COV-2 coronavirus infection in a particular health area.