Post-Covid liver disease in 14 patients in Delhi hospital

Liver abscess is commonly caused by a parasite known as entamoeba histolytica which is transmitted through contaminated food and water, doctors said.
Poor nutrition, steroid usage could have compromised the liver of some patients
Poor nutrition, steroid usage could have compromised the liver of some patients

NEW DELHI:  Post-Covid complications continue to be reported among recovered patients in the national capital with the latest coming from city-based Sir Ganga Ram Hospital where 14 post-Covid patients were diagnosed with ‘unusually large’ and multiple liver abscesses. One such patient succumbed due to massive bleeding in abdomen, the authorities said on Thursday.

Liver abscess (pus formation in liver) is commonly caused by a parasite known as entamoeba histolytica which is transmitted through contaminated food and water. “In the last two months, we saw for the first time unusually large and multiple liver abscesses in 14 patients after their recovery from Covid-19 infection,” said the hospital in a statement.

These patients, 10 men and 4 women in the 28-74 age group, were brought to the hospital in the last two months with “unusual manifestations”. Of these 14, eight had received steroids during Covid treatment.
Doctors suspect that poor nutrition and use of steroids could have led to pus formation. Six patients had multiple large abscesses in both lobes of liver, of which five patients had unusually large abscess (more than 8 cm), the largest being 19 cm in size, the doctor said.

“What we found unusual was that within 22 days after recovery from Covid, patients who were otherwise immunocompetent, had large areas of both lobes of liver filled with pus at multiple locations, requiring hospitalisation,” said Dr Anil Arora, chairman, institute of liver gastroenterology and pancreaticobiliary sciences, Sir Ganga Ram Hospital.

Doctors said all the patients had “fever and upper abdominal pain and three of them also had associated gastrointestinal bleeding”. “Three patients who had blood during stool discharge showed ulcers in their large intestine. Thirteen out of 14 patients were successfully treated,” Arora added.

A high index of suspicion of such infections in the form of fever and pain in right abdomen merits early diagnosis, said Dr Praveen Sharma, senior consultant, gastroenterology, at the hospital. “We believe that suppression of immunity by Covid-19 along with use of steroids to treat the infection per se led to the development of this complication,” Arora said. Entamoeba histolytica is a common parasite seen in countries with poor sanitation services. It causes amoebiasis, an intestinal infection.

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