Transient immune hepatitis as post-coronavirus disease complication: A case report

Table 2 Differential diagnosis of hepatic cytolysis

Hypothesis	Investigation and result
Drug-induced liver injury	No drugs recently administered
Systemic replication of SARS-CoV-2	Negative SARS-CoV-2 RT-PCR from blood and nasopharyngeal + oropharyngeal swabs
COVID-19 cytokine storm	Timing–day 24
	Normal inflammatory markers
	Normal chest CT at baseline and on day 24
Infections with other hepatotropic viruses	Negative: HAV IgM, HBsAg, HCV Abs, HEV IgM and HEV-RNA, adenovirus IgM, coxsackie virus IgM, echo virus IgM, HSV1+2 IgM, EBV IgM, CMV IgM.
Post-COVID-19 immune hepatitis	Rapidly increasing SARS-CoV-2 antibodies (chemiluminescence)

COVID-19: Coronavirus disease-19; SARS-CoV-2: Severe acute respiratory syndrome coronavirus 2; RT-PCR: Real-time reverse transcription polymerase chain reaction; IL-6: Interleukin 6; CT: Computed tomography; HAV: Hepatitis A virus; HCV Abs: Hepatitis C virus antibodies; HEV: Hepatitis E virus; HSV: Herpes simplex virus; HBsAg: Hepatitis B surface antigen; IgM: Immunoglobulin M; EBV: Epstein-Barr virus; CMV: Cytomegalovirus.