Background Infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may not elicit lifelong protective immunity and reinfection could occur. Liver function impairment is a common manifestation of coronavirus disease 2019 (COVID-19). However, acute hepatic failure in the setting of COVID-19 is very rare. Case presentation We report the case of a 47-year-old woman who presented with acute abdominal pain and vomiting. Abdominal examination revealed a soft and lax abdomen with mild tenderness in the right upper quadrant. The patient recovered from COVID-19 2 months previously with negative results on reverse transcription-polymerase chain reaction (RT-PCR). Laboratory investigations revealed markedly elevated transaminases with normal results on viral hepatitis serology panel and undetectable blood paracetamol level. Prior to admission, the patient underwent RT-PCR for SARS-CoV-2, which revealed a positive result. The patient experienced rapid deterioration in the neurological status with a remarkable increase in the liver enzyme levels. Despite aggressive resuscitation, the patient suffered irreversible cardiac arrest and died. Conclusion Fulminant hepatic failure is a rare manifestation in patients with re-positive RT-PCR tests for SARS-CoV-2. Clinicians should maintain a high index of suspicion for hepatic injury with active monitoring of liver enzymes.
【저자키워드】 COVID-19, Re-infection, case reports, liver failure, Re-positive test, 【초록키워드】 coronavirus disease, SARS-CoV-2, coronavirus, serology, abdominal pain, RT-PCR, Reinfection, Deterioration, protective immunity, Viral hepatitis, Patient, Mild, Admission, Blood, liver enzymes, RT-PCR test, neurological, liver enzyme, Paracetamol, acute respiratory syndrome, positive result, transaminase, vomiting, impairment, hepatic injury, abdomen, laboratory investigation, fulminant hepatic failure, died, the patient, elevated, occur, elicit, increase in, maintain, suffered, hepatic failure, undetectable, 【제목키워드】 Case report, Patient, fulminant hepatic failure,