Delhi / Unusually large pus found in livers of post-COVID-19 patients; 1 dead: Delhi hospital

New Delhi: As many as 14 patients who recovered from Covid-19 were diagnosed with “unusually large” and multiple liver abscesses as post-disease complications in the past two months, authorities at Delhi’s Ganga Ram Hospital said on Thursday.

Of the 14 patients, eight had received steroids during the course of their Covid-19 treatment, while one succumbed to the post-disease complication following massive bleeding, doctors said.

Dr Anil Arora, the chairman at the Institute of Liver Gastroenterology and Pancreaticobiliary Sciences, Sir Ganga Ram Hospital, the hospital received 10 men and four women between 28 and 74 years with liver abscesses in the past two months.

“What we found unusual was that within 22 days of the recovery from Covid-19, patients who were otherwise immunocompetent had large areas of both lobes of their liver filled with pus at multiple locations, requiring drainage and hospitalisation,” Dr Arora added.

According to doctors, poor nutrition and use of steroids could have resulted in the pus formation and the abscesses.

The sole deceased suffered from massive bleeding after the abscess in the abdominal cavity ruptured. “All the remaining patients are stable and have now been discharged,” Dr Arora informed.

Last month, five cases of Cytomegalovirus (CVM) related rectal bleeding among patients who recovered from Covid-19 were reported in Ganga Ram Hospital. These patients had complained of bleeding in stool discharge followed by abdominal pain, officials said.

In a statement released at that time, the hospital said that the patients of CMV infection were otherwise immunocompetent.

What causes formation of liver abscesses?

Doctors at Ganga Ram Hospital said that liver abscess – pus formation in liver — is usually caused by a parasite called ‘entamoeba histolytica’, which is transmitted via contaminated water and food.

Following the occurrence of the infection, the parasite may get carried by the bloodstream from a patient’s intestines to the liver, thereby causing liver abscess.

What was the nature of the post-Covid complications in the 14 patients?

According to Dr Arora, of the eight patients who were treated with steroids while infected with Covid-19, six had multiple large abscesses in both lobes of the liver – the largest being 19cm in size.

“Three patients, who had blood during stool discharge, showed ulcers in the large intestine, which were detected by colonoscopy,” he added.

What could have caused the liver abscesses?

Suppression of immunity by Covid-19 besides usage of steroids to treat the disease are probably some factors that caused the formation of liver abscesses in the 14 patients, Dr Arora said.

He added that “low index of suspicion for liver abscess and delay in treatment in patients recuperating from coronavirus infection,” could have also contributed to the condition.