tetano
Editor, Senior Moderator
BMC Infect Dis
. 2021 Sep 3;21(1):901.
doi: 10.1186/s12879-021-06605-7.
COVID-19: a fatal case of acute liver failure associated with SARS-CoV-2 infection in pre-existing liver cirrhosis
Jana Ihlow[SUP] #[/SUP][SUP] 1 [/SUP], Alexander Seelhoff[SUP] #[/SUP][SUP] 2 [/SUP], Victor M Corman[SUP] #[/SUP][SUP] 3 [/SUP], Achim D Gruber[SUP] #[/SUP][SUP] 4 [/SUP], Simon Dökel[SUP] #[/SUP][SUP] 4 [/SUP], Jenny Meinhardt[SUP] #[/SUP][SUP] 5 [/SUP], Helena Radbruch[SUP] #[/SUP][SUP] 5 [/SUP], Ernst Späth-Schwalbe[SUP] #[/SUP][SUP] 6 [/SUP], Sefer Elezkurtaj[SUP] #[/SUP][SUP] 7 [/SUP], David Horst[SUP] #[/SUP][SUP] 7 [/SUP], Hermann Herbst[SUP] #[/SUP][SUP] 8 [/SUP]
Affiliations
Abstract
Background: The detection of severe acute respiratory syndrome coronavirus (SARS-CoV-2) is challenging, particularly in post-mortem human tissues. However, there is increasing evidence for viral SARS-CoV-2 manifestation in non-respiratory tissues. In this context, it is a current matter of debate, whether SARS-CoV-2 shows hepatotropism.
Case presentation: Here, we report a case of an 88-year-old women with massive SARS-CoV-2 viremia, severe jaundice and clinical signs of an acute hepatitis, who died within a few days from an acute liver failure without showing any clinical signs of pneumonia. Autopsy revealed a severe chronic and acute liver damage with bile duct infestation by SARS-CoV-2 that was accompanied by higher expressions of angiotensin-converting enzyme-2 (ACE2), Cathepsin L and transmembrane serine protease 2 (TMPRSS2).
Conclusion: Our findings indicate an enhanced biliary susceptibility to viral infection with SARS-CoV-2, that might have resulted from pre-existing severe liver damage. Furthermore, our findings emphasize the differential diagnosis of coronavirus disease 2019 (COVID-19)-associated liver failure in the clinical setting of an inexplicable jaundice.
Keywords: Bile duct; COVID-19; Case report; Hepatitis; SARS-CoV-2.
. 2021 Sep 3;21(1):901.
doi: 10.1186/s12879-021-06605-7.
COVID-19: a fatal case of acute liver failure associated with SARS-CoV-2 infection in pre-existing liver cirrhosis
Jana Ihlow[SUP] #[/SUP][SUP] 1 [/SUP], Alexander Seelhoff[SUP] #[/SUP][SUP] 2 [/SUP], Victor M Corman[SUP] #[/SUP][SUP] 3 [/SUP], Achim D Gruber[SUP] #[/SUP][SUP] 4 [/SUP], Simon Dökel[SUP] #[/SUP][SUP] 4 [/SUP], Jenny Meinhardt[SUP] #[/SUP][SUP] 5 [/SUP], Helena Radbruch[SUP] #[/SUP][SUP] 5 [/SUP], Ernst Späth-Schwalbe[SUP] #[/SUP][SUP] 6 [/SUP], Sefer Elezkurtaj[SUP] #[/SUP][SUP] 7 [/SUP], David Horst[SUP] #[/SUP][SUP] 7 [/SUP], Hermann Herbst[SUP] #[/SUP][SUP] 8 [/SUP]
Affiliations
- PMID: 34479499
- DOI: 10.1186/s12879-021-06605-7
Abstract
Background: The detection of severe acute respiratory syndrome coronavirus (SARS-CoV-2) is challenging, particularly in post-mortem human tissues. However, there is increasing evidence for viral SARS-CoV-2 manifestation in non-respiratory tissues. In this context, it is a current matter of debate, whether SARS-CoV-2 shows hepatotropism.
Case presentation: Here, we report a case of an 88-year-old women with massive SARS-CoV-2 viremia, severe jaundice and clinical signs of an acute hepatitis, who died within a few days from an acute liver failure without showing any clinical signs of pneumonia. Autopsy revealed a severe chronic and acute liver damage with bile duct infestation by SARS-CoV-2 that was accompanied by higher expressions of angiotensin-converting enzyme-2 (ACE2), Cathepsin L and transmembrane serine protease 2 (TMPRSS2).
Conclusion: Our findings indicate an enhanced biliary susceptibility to viral infection with SARS-CoV-2, that might have resulted from pre-existing severe liver damage. Furthermore, our findings emphasize the differential diagnosis of coronavirus disease 2019 (COVID-19)-associated liver failure in the clinical setting of an inexplicable jaundice.
Keywords: Bile duct; COVID-19; Case report; Hepatitis; SARS-CoV-2.