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Clinical Reviews

COVID-19 as a cause of acute hepatitis


Miró Vicedo Ca, Ruipérez Cebrián Cb, González de Dios Jc

a MIR-Pediatría. Servicio de Pediatría. Hospital General Universitario Dr. Balmis. Alicante, España.
bServicio de Pediatría. Hospital General Universitario Dr. Balmis. Alicante, España.
cServicio de Pediatría. Hospital General Universitario de Alicante. Departamento de Pediatría. Universidad Miguel Hernández. ISABIAL-Instituto de Investigación Sanitaria y Biomédica. Alicante. España.

Reference of this article.:

Miró Vicedo C, Ruipérez Cebrián C, González de Dios J. COVID-19 como causa de hepatitis aguda . Rev Pediatr Aten Primaria. 2022;24:417-9..

Published in Internet: 29/12/2022


In the pathogenesis of acute liver damage related to SARS-CoV-2 infection, several hypotheses have been made: hepatotoxicity of drugs in the treatment of COVID-19; cytokine storm triggered by the immune hyperactivation; liver damage secondary to a situation of shock and hypoperfusion; and direct cytopathic effect of the virus.

We repot the case of a previously healthy 10-year-old boy who, in December 2020, developed acute hepatitis with a cytolytic pattern (ALT 1823 U/L and AST 1092 U/L), without associated increase in other cholestatic parameters, and who after the study, it could only be attributed to COVID-19, since he did not receive drugs that could damage the liver, nor did he present hemodynamic instability or involvement of other organs or multi-inflammatory disease. The diagnosis was made after exclusion of other microbiological causes and thanks to the detection of the virus both in the respiratory tract and in feces. A discussion is made about the possible direct cytotoxic effect of the virus and the current literature that supports this hypothesis, as well as the practicality of PCR detection of SARS-CoV-2 in feces for the diagnosis of COVID-19 with gastrointestinal involvement or liver-predominant involvement.

Keywords: Hepatitis. SARS-CoV-2. COVID-19.


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