Supplementary Material for: COVID-19-induced cholangiopathy: a case report.

A 60-year-old male patient with multiple comorbidities was admitted with a fever, chills, and a cough lasting one day. In the emergency department, the patient tested positive for COVID-19 by PCR. A chest X-ray suggested pulmonary edema, leading to the patient's intubation and admission for COVID-19 pneumonia with pulmonary edema. During hospitalization, the patient developed cardiac complications, which were addressed. Approximately one week after admission, the patient's hepatic enzymes began to rise. Drug-induced liver injury was suspected, prompting the initiation of ursodeoxycholic acid (UDCA) and the cessation of the offending drugs. However, liver function tests (LFTs) remained elevated. An MRCP was performed, and COVID-19-induced cholangiopathy was suspected. The UDCA dosage was doubled, resulting in a decrease in LFTs. Despite the markers not returning to baseline, the patient chose to discharge against medical advice

1例伴多种基础疾病的60岁男性患者，因发热、寒战及持续1天的咳嗽就诊入院。急诊就诊时，患者新型冠状病毒（COVID-19）聚合酶链式反应（PCR）检测结果呈阳性。胸部X线检查提示肺水肿，遂为患者实施气管插管，并以新型冠状病毒肺炎合并肺水肿收入院治疗。住院期间，患者出现心脏并发症，经对症处置后得到控制。入院约1周后，患者肝酶水平开始升高。临床怀疑为药物性肝损伤，遂启动熊去氧胆酸（ursodeoxycholic acid, UDCA）治疗，并停用致病药物。但肝功能检测（liver function tests, LFTs）结果仍持续升高。遂行磁共振胰胆管造影（magnetic resonance cholangiopancreatography, MRCP）检查，临床怀疑为新型冠状病毒感染相关性胆管病。将熊去氧胆酸剂量加倍后，患者肝功能检测指标逐渐下降。尽管相关指标未恢复至基线水平，患者仍选择违背医嘱自行出院。