Published online Jun 6, 2021. doi: 10.12998/wjcc.v9.i16.4032
Peer-review started: January 12, 2021
First decision: February 11, 2021
Revised: February 25, 2021
Accepted: March 24, 2021
Article in press: March 24, 2021
Published online: June 6, 2021
We report a case of post-coronavirus disease (COVID) immune hepatitis occurring in a young male with no pre-existing comorbidities.
A previously healthy 21-year-old male patient was admitted to our hospital with mild COVID-19. During the course of in-hospital isolation and monitoring, he developed an alanine aminotransferase (ALT) and aspartate aminotransferase (AST) increase, with the enzymes peaking at day 24 (ALT 15 times the upper normal limit), with preserved liver function. The liver enzyme increase occurred 20 d after the complete clinical remission of COVID-19, and ALT dynamics paralleled the increase in total antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The case was interpreted as post-COVID immune hepatitis, with extensive laboratory investigations excluding other potential causes. The hepatocytolysis remitted 20 d after the peak ALT, without further intervention, with complete recovery, but the total anti-SARS-CoV-2 antibodies continued to increase the next 5 mo following the acute infection.
Close attention should also be paid to young patients with mild forms of disease, and a high index of suspicion should be maintained for post-COVID complica
Core Tip: We report an interesting case of post-coronavirus disease immune hepatitis occurring in a young male with no pre-existing comorbidities. The patient acquired the infection from an asymptomatic carrier of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). He developed a mild form of disease, but after apparent clinical remission and real-time reverse transcription polymerase chain reaction negative conversion, an important increase in liver enzymes was recorded in parallel with an increasing SARS-CoV-2 antibody titer.