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.