Abstract and Introduction
The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a highly infectious viral disease that predominantly causes respiratory symptoms. Elevated liver enzymes have been reported during the course of disease and appear to be common. We present a 56-year-old woman with a history of decompensated alcoholic cirrhosis who presented with abdominal pain, fever and diarrhoea and was found to have acute on chronic liver failure secondary to SARS-CoV-2 infection. The patient was treated with empiric antibiotic and supportive care with subsequent improvement.
The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of a worldwide pandemic affecting more than 200 countries. There have been greater than 1 million cases worldwide with the overall case fatality rate (CFR) ranging between 0.4% and 7.7%. The clinical spectrum of SARS-CoV-2 infection ranges from asymptomatic to mild lower respiratory syndrome, acute respiratory distress syndrome (ARDS) requiring mechanical ventilation and multiple organ failure. The most common clinical manifestations include fever, fatigue, dry cough, dyspnoea, anosmia, loss of taste and myalgia. Other atypical presentations include nausea, vomiting and/or diarrhoea. Typically, laboratory findings include leucocytosis, lymphopenia, elevated lactate dehydrogenase (LDH), elevated C-reactive protein (CRP), elevated erythrocyte sedimentation rate (ESR), elevated ferritin and elevated aminotransferases. We present a case of acute on chronic liver failure caused by SARS-CoV-2 infection in a patient with decompensated alcoholic cirrhosis.
Liver International. 2020;40(7):1590-1593. © 2020 Blackwell Publishing