Introduction
In December 2019, pneumonia cases with clinical signs and symptoms that closely resemble viral pneumonia were reported in Wuhan, Hubei, China (1). Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the newly emerging coronavirus, was termed by the World Health Organization (WHO) shortly after the initial instances of lower respiratory tract infection, and the illness that resulted was called coronavirus disease 2019 (COVID-19) (2,3). In the twenty-first century, three viral epidemics have been linked to Coronaviruses (CoVs): SARS, the Middle East respiratory syndrome (MERS), and COVID-19 (4).
There is ample evidence of liver failure in COVID-19 patients (5–9). The presence of increased liver enzymes in SARS-CoV-2 patients was discovered in 75 of 148 patients (10). Aspartate aminotransferase (AST) increased in 62 percent of intensive care unit (ICU) patients compared to 25 percent of patients who did not receive ICU treatment, suggesting that more severe illness is associated with deterioration of liver enzymes in this population (1). A retrospective cohort study has indicated that acute liver damage is frequent in SARS-CoV-2 positive patients, although usually mild. However, a severe disease course should be expected in the 6.4 percent of individuals with severe liver damage. 67% of patients who tested positive for SARS-COV-2 had higher ALT levels than those who tested negative (11). Here, we report a case of acute liver failure in a pediatrician with COVID-19 infection without a history of preexisting liver disease. Unfortunately, the patient passed away several days after ICU admission. We desire to highlight the knowledge that requires further studies related to liver failure in COVID-19 patients.