Lai Pei-Hsuan, Ding Dah-Ching
Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Hualien 970, Taiwan.
World J Clin Cases. 2023 Jan 16;11(2):472-478. doi: 10.12998/wjcc.v11.i2.472.
Coronavirus disease 2019 (COVID-19) has spread rapidly, resulting in a pandemic in January 2020. Few studies have focused on the natural history and consequences of acute liver injury (ALI) in mild or asymptomatic COVID-19 patients, manifested by elevated aminotransferase levels. ALI is usually expected for severe COVID-19 cases. Here, we present a COVID-19 case with mild respiratory symptoms and significantly elevated alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels.
A 60-year-old woman without medical history or chronic illness received three COVID-19 vaccinations since the start of the pandemic. The patient was infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and presented with mild symptoms on July 12, 2022. Post-recovery, she underwent an examination at our hospital on August 30, 2022. AST and ALT levels in the liver function test were 207 U/L (normal value < 39, 5.3-fold increase) and 570 U/L (normal value < 52, 10.9-fold increase), respectively. The patient was diagnosed with ALI, and no treatment was prescribed. The following week, blood tests showed a reduction in both levels (ALT 124 U/L, AST 318 U/L). Two weeks later, AST and ALT levels had decreased to near the expected upper limits (ALT 40 U/L, AST 76 U/L).
Clinicians should pay attention to liver function testing during COVID-19 recovery regardless of the disease's severity.
2019年冠状病毒病（COVID-19）迅速传播，于2020年1月引发大流行。很少有研究关注轻度或无症状COVID-19患者急性肝损伤（ALI）的自然病史及后果，其表现为转氨酶水平升高。ALI通常见于重症COVID-19病例。在此，我们报告1例有轻度呼吸道症状且丙氨酸转氨酶（ALT）和天冬氨酸转氨酶（AST）水平显著升高的COVID-19病例。
一名60岁无病史或慢性病的女性自疫情开始以来接种了3剂COVID-19疫苗。该患者感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2），于2022年7月12日出现轻度症状。康复后，她于2022年8月30日在我院接受检查。肝功能检查中AST和ALT水平分别为207 U/L（正常值<39，升高5.3倍）和570 U/L（正常值<52，升高10.9倍）。该患者被诊断为ALI，未予治疗。接下来的一周，血液检查显示这两个水平均下降（ALT 124 U/L，AST 318 U/L）。两周后，AST和ALT水平降至接近预期上限（ALT 40 U/L，AST 76 U/L）。
无论COVID-19病情严重程度如何，临床医生在患者康复过程中均应关注肝功能检查。
