{
  "abstract": "Although COVID-19-associated liver abnormalities are documented, the link between delayed viral clearance, IgG seroconversion, and inflammation remains poorly defined, particularly in Sub-Saharan African populations, where baseline liver enzymes differ from Western standards. In 38 SARS-CoV-2-positive individuals monitored at D0, D14, and D30, we quantified liver biomarkers (ALT, AST, BILT, BILD) by spectrophotometry (COBAS), plasma IL-6 by Luminex, viral load (N and ORF1ab genes) by RT-qPCR, and IgG/IgM serology. Analyses were performed in GraphPad Prism v9.0. ALT and AST rose transiently at D14, returning to baseline by D30. IL-6 peaked at D14 and correlated positively with BILT (r = 0.64, p = 0.001) and BILD (r = 0.54, p = 0.006). ORF1ab Ct at D14 correlated negatively with ALT at D0 (r = −0.67, p = 0.004) and D14 (r = −0.71, p = 0.006); N gene Ct at D14 correlated with ALT at D0 (r = −0.61, p = 0.011). Mixed-effects models identified IL-6 as the sole independent predictor of AST (β = 3.04, p = 0.005) and Ct N gene as an independent predictor of direct bilirubin (β = −0.003, p = 0.025), supporting a dual-pathway model of COVID-19-associated cholestasis. Paradoxically, IgG seropositivity independently predicted higher direct bilirubin (β = 0.06, p = 0.030) but did not mark biliary normalisation. Elevated ALT and BILT at D0 were associated with detectable viral RNA beyond D14 (P = 0.03). Participants aged >30 years drove rising BILD, with significant increases at D14 (P = 0.03) and D30 (P = 0.04) versus D0. COVID-19 liver injury follows a biphasic course: D14 alterations are inflammation-driven (IL-6), while D30 abnormalities track with delayed viral RNA clearance independent of IgG seroconversion. Extended hepatic monitoring is warranted, especially in older patients with delayed viral clearance in resource-limited settings.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Biochemistry, University of Yaoundé I, Yaoundé, Cameroon",
    "Centre for Research on Emerging and Re-emerging Diseases, Institute of Medical Research and Medicinal Plant Studies, Ministry of Scientific Research and Innovation, Yaoundé, Cameroon",
    "Catholic University of Central Africa, Higher School of Health Sciences, Yaoundé, Cameroon",
    "Immunology laboratory, The Biotechnology Centre, University of Yaoundé I, Yaoundé, Cameroon",
    "Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon",
    "University Teaching Hospital Centre of Yaoundé, Yaoundé, Cameroon",
    "Department of Biomedical Sciences, Faculty of Health Sciences, University of Buea, Buea, Cameroon",
    "National Public Health Laboratory, Ministry of Public Health, Yaoundé, Cameroon"
  ],
  "article_type": "Research Article",
  "arxiv": null,
  "author_total": 17,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Modeste R. Ngamaleu"
    },
    {
      "affs": [
        1
      ],
      "name": "Hillary Tene"
    },
    {
      "affs": [
        2
      ],
      "name": "Romeo Djounda"
    },
    {
      "affs": [
        3
      ],
      "name": "Rachel Minomo"
    },
    {
      "affs": [
        4
      ],
      "name": "Micheal Besong"
    },
    {
      "affs": [
        5
      ],
      "name": "Honore Awanakam"
    },
    {
      "affs": [
        6
      ],
      "name": "Christela Djeukeng"
    },
    {
      "affs": [
        7
      ],
      "name": "Kevine Tchamda"
    },
    {
      "name": "Reine Seumko’o"
    },
    {
      "name": "Tatiane Feugo"
    },
    {
      "name": "Antonin Wilson Ndjitoyap Ndam"
    },
    {
      "name": "Antoine B. Siafa"
    },
    {
      "name": "Eleonore Ngounoue"
    },
    {
      "name": "Rene Essomba"
    },
    {
      "name": "Charles Kouanfack"
    },
    {
      "name": "Jude Bigoga"
    },
    {
      "name": "Forgu Esemu Livo"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/b5xv2xbc60a2y.bib",
  "cited_by": 0,
  "doi": "10.1371/journal.pone.0357503",
  "fulltext_url": null,
  "id": "b5xv2xbc60a2y",
  "issns": [
    "1932-6203"
  ],
  "landing_url": "https://doi.org/10.1371/journal.pone.0357503",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2725|COVID-19 Clinical Research Studies"
    ],
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      "plos",
      "/Biology and life sciences/Anatomy/Body fluids/Bile/Bilirubin"
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      "/Biology and life sciences/Organisms/Viruses/Viral pathogens/Coronaviruses/SARS coronavirus/SARS CoV 2"
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      "/Biology and life sciences/Physiology/Body fluids/Bile/Bilirubin"
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      "/Medicine and health sciences/Immunology/Immune response/Inflammation"
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      "/Medicine and health sciences/Medical conditions/Infectious diseases/Viral diseases/COVID 19"
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      "/Medicine and health sciences/Pathology and laboratory medicine/Pathogens/Microbial pathogens/Viral pathogens/Coronaviruses/SARS coronavirus/SARS CoV 2"
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  "pdf_url": "https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0357503&type=printable",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-16",
  "publisher": "Public Library of Science",
  "ris": "https://research.draconitic.com/paper/b5xv2xbc60a2y.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:23Z",
      "native_id": "10.1371/journal.pone.0357503",
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      "url": "https://doi.org/10.1371/journal.pone.0357503"
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  "subjects": [
    {
      "field": "biology",
      "origin": "plos:immunology",
      "subfield": "immunology"
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    {
      "field": "biology",
      "origin": "plos:microbiology",
      "subfield": "microbiology"
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      "field": "medicine",
      "origin": "plos:anatomy",
      "subfield": "physiology"
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  "title": "Early inflammation-driven damage and delayed viral clearance are associated with prolonged biliary perturbation in a Cameroonian cohort of COVID-19 patients",
  "title_text": "Early inflammation-driven damage and delayed viral clearance are associated with prolonged biliary perturbation in a Cameroonian cohort of COVID-19 patients",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:23Z",
  "url": "https://research.draconitic.com/paper/b5xv2xbc60a2y",
  "venue": "PLOS One",
  "versions": []
}