Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 16, 2023; 11(2): 472-478
Published online Jan 16, 2023. doi: 10.12998/wjcc.v11.i2.472
Acute liver injury in a COVID-19 infected woman with mild symptoms: A case report
Pei-Hsuan Lai, Dah-Ching Ding
Pei-Hsuan Lai, Dah-Ching Ding, Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Hualien 970, Taiwan
Author contributions: Ding DC and Lai PH conceptualized the study; Lai PH contributed to data curation; Ding DC and Lai PH wrote the original draft; Ding DC and Lai PH were involved in writing and review.
Informed consent statement: Informed written consent was obtained from the patients for the publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dah-Ching Ding, MD, PhD, Professor, Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, No. 707 Chung-Yang Road, Hualien 970, Taiwan. dah1003@yahoo.com.tw
Received: November 15, 2022
Peer-review started: November 15, 2022
First decision: November 25, 2022
Revised: December 5, 2022
Accepted: December 23, 2022
Article in press: December 23, 2022
Published online: January 16, 2023
Abstract
BACKGROUND

Coronavirus disease 2019 (COVID-19) has spread rapidly, resulting in a pandemic in January 2020. Few studies have focused on the natural history and consequences of acute liver injury (ALI) in mild or asymptomatic COVID-19 patients, manifested by elevated aminotransferase levels. ALI is usually expected for severe COVID-19 cases. Here, we present a COVID-19 case with mild respiratory symptoms and significantly elevated alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels.

CASE SUMMARY

A 60-year-old woman without medical history or chronic illness received three COVID-19 vaccinations since the start of the pandemic. The patient was infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and presented with mild symptoms on July 12th, 2022. Post-recovery, she underwent an examination at our hospital on August 30th, 2022. AST and ALT levels in the liver function test were 207 U/L (normal value < 39, 5.3-fold increase) and 570 U/L (normal value < 52, 10.9-fold increase), respectively. The patient was diagnosed with ALI, and no treatment was prescribed. The following week, blood tests showed a reduction in both levels (ALT 124 U/L, AST 318 U/L). Two weeks later, AST and ALT levels had decreased to near the expected upper limits (ALT 40 U/L, AST 76 U/L).

CONCLUSION

Clinicians should pay attention to liver function testing during COVID-19 recovery regardless of the disease’s severity.

Keywords: COVID-19, Hepatitis, Pneumonia, Aspartate aminotransferase, Alanine aminotransferase, Case report

Core Tip: Even though elevated aminotransferase levels and acute liver injury (ALI) are expected for severe coronavirus disease 2019 cases, here we report a rare case of ALI following a mild infection. We provide detailed information on ALI’s natural course in such patients.