Pancytopenia and Acute Liver Failure Caused by Mild COVID-19 in an Older Patient: A Case Report.

An 89-year-old woman, living independently, presented to a community hospital with complaints of back pain and anterior chest pain after a fall at home. During her hospitalization, she was infected with COVID-19, and although her fever temporarily resolved with symptomatic treatment, she developed pancytopenia and liver dysfunction along with fever again. Blood tests and imaging studies ruled out acute cholangitis or hepatitis virus infection, and a diagnosis of myelosuppression and liver dysfunction due to multi-system inflammatory syndrome (MIS) was made. Treatment with prednisolone was initiated, and improvement in liver enzyme levels and pancytopenia was observed, indicating that steroid therapy was effective. Still, after steroid discontinuation, the patient again presented with pancytopenia. This case demonstrates the potential of multiorgan damage that can occur after a COVID-19 infection and emphasizes the importance of tapering and monitoring steroid therapy, especially in the management of myelosuppression and liver dysfunction due to MIS, during a COVID-19 infection. This may contribute to improved patient prognosis.