World J Clin Cases . Acute liver injury in a COVID-19 infected woman with mild symptoms: A case report

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World J Clin Cases


. 2023 Jan 16;11(2):472-478.
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 ¹ , Dah-Ching Ding ²



Affiliations

• PMID: 36686361
• PMCID: PMC9850972
• DOI: 10.12998/wjcc.v11.i2.472

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 12^th, 2022. Post-recovery, she underwent an examination at our hospital on August 30^th, 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: Alanine aminotransferase; Aspartate aminotransferase; COVID-19; Case report; Hepatitis; Pneumonia.