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Severe liver failure during SARS-CoV-2 infection
  1. Sabine Weber1,
  2. Julia Mayerle1,
  3. Michael Irlbeck2,
  4. Alexander L Gerbes1
  1. 1 Department of Medicine II, University Hospital Munich, Munich, Bavaria, Germany
  2. 2 Department of Anesthesiology, University Hospital Munich, Munich, Bavaria, Germany
  1. Correspondence to Dr Sabine Weber, Department of Medicine II, University Hospital Munich, Munich 81377, Germany; sabine.weber{at}med.uni-muenchen.de

https://doi.org/10.1136/gutjnl-2020-321350

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    We read with interest the recently described affections of the GI system in coronavirus disease (COVID-19).1 2 In addition to the effects on the gut, mild abnormalities in liver aminotransferase levels have been observed.3 4 We here report a previously non-described severe liver failure in a patient with COVID-19.

    A 65-year-old man was admitted to our emergency department with fever up to 40°C, dry cough and dyspnoea. The chest CT scan showed typical features of COVID-19, such as ground-glass opacities and peripheral consolidations. A throat swab confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Aminotransferase concentrations were slightly increased (alanine aminotransferase (ALT) 69 U/L and aspartate aminotransferase (AST) 92 U/L; upper limit of normal (ULN) ≤49 U/L). He had been receiving long-term treatment with hydrochlorothiazide and ramipril for arterial hypertension as sole medications and had no history of liver disease.

    The patient was admitted to the isolation ward and was given supplementary oxygen. He received piperacillin/tazobactam and azithromycin according to hospital standards, as well as paracetamol (1 g, up to two times per day). …

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    Footnotes

    • Contributors SW: data collection, first draft of the manuscript. JM, MI and ALG: supervision and revision of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; internally peer reviewed.