Elevated transaminases in a COVID-19 positive patient at term of gestation: a case report: Covid19 and pregnancy

Elevated transaminases in a COVID-19 positive patient at term of gestation: a case report

Covid19 and pregnancy

Authors

  • Claudia Nkeih Department of Obstetrics and Gynecology, St. John's Episcopal Hospital, Far Rockaway, NY 11692, USA
  • Giovanni Sisti Department of Obstetrics and Gynecology, New York Health and Hospitals/Lincoln, Bronx, 10451, NY USA
  • Antonio Schiattarella a:1:{s:5:"en_US";s:124:"Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy";}

Keywords:

covid19, sars-cov-2, pregnancy, liver injury, transaminases, newborm

Abstract

Background: The coronavirus disease 2019 (COVID-19) pandemic is caused by the severe acute respiratory syndrome 2 virus (SARS-CoV-2) and it is spreading worldwide with an alarming high transmission rate. SARS-CoV-2 usually attacks the lungs causing a wide range of symptoms ranging from mild dyspnea to severe shortness of breath requiring intubation. Elevation of liver transaminases in the patients’ sera has been described in up to 53% of the COVID-19 positive patients. The underlying pathogenic mechanisms of the virus on the liver cells are unclear and only few hypotheses are currently available. Data on COVID-19 in pregnant women are lacking and the management of COVID-19 pregnant women is challenging. An elevation of the transaminases during pregnancies infected by SARS-CoV-2 has never been described before.

Methods: Here we presented the case of a 29 years-old patient at 38 weeks of gestation COVID-19 positive with elevated transaminases.

Results: The patient showed a progressive decrease of transaminases after the delivery of the fetus. We provided details about the daily transaminases trend, the therapy used and the maternal/neonatal outcomes.

Conclusions: We speculate that in our case the delivery of the fetus contributed to the normalization of the liver enzymes. In patients affected by COVID-19, at term of gestation, with elevated transaminases, delivery of the fetus is an appealing option. If confirmed by larger studies, our proposed management might be incorporated in the obstetrical management guidelines for COVID-19 positive patients.

 

References

Carugno J, Sardo ADS, Alonso L, et al. COVID-19 pandemic. Impact on hysteroscopic procedures. A consensus statement from the Global Congress of Hysteroscopy Scientific Committee. J Minim Invasive Gynecol. 2020 Apr 24;

Bizzarri M, Laganà AS, Aragona D, Unfer V. Inositol and pulmonary function. Could myo-inositol treatment downregulate inflammation and cytokine release syndrome in SARS-CoV-2? Eur Rev Med Pharmacol Sci. 2020;24(6):3426–32.

Franchi M, Bosco M, Garzon S, et al. Management of obstetrics and gynaecological patients with COVID-19. Ital J Gynaecol Obs. 2020;32(1):6–19.

Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet (London, England). 2020;395(10229):1054–62.

Li X, Geng M, Peng Y, Meng L, Lu S. Molecular immune pathogenesis and diagnosis of COVID-19. J Pharm Anal. 2020 Mar;

Xu Z, Shi L, Wang Y, et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med. 2020;8(4):420–2.

Fan Z, Chen L, Li J, et al. Clinical Features of COVID-19-Related Liver Damage. Clin Gastroenterol Hepatol. 2020 Apr 10;

Wang D, Hu B, Hu C, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020 Feb 7;

Gagnier JJ, Kienle G, Altman DG, Moher D, Sox H, Riley D. The CARE Guidelines: Consensus-based Clinical Case Reporting Guideline Development. Glob Adv Heal Med. 2013 Sep 17;2(5):38–43.

Conti P, Ronconi G, Caraffa A, et al. Induction of pro-inflammatory cytokines (IL-1 and IL-6) and lung inflammation by Coronavirus-19 (COVI-19 or SARS-CoV-2): anti-inflammatory strategies. J Biol Regul Homeost Agents. 2020;34(2).

Zhang C, Shi L, Wang F-S. Liver injury in COVID-19: management and challenges. lancet Gastroenterol Hepatol. 2020;5(5):428–30.

Feng G, Zheng KI, Yan Q-Q, et al. COVID-19 and Liver Dysfunction: Current Insights and Emergent Therapeutic Strategies. J Clin Transl Hepatol. 2020 Mar 28;8(1):1–7.

Chai X, Hu L, Zhang Y, et al. Specific ACE2 Expression in Cholangiocytes May Cause Liver Damage After 2019-nCoV Infection. bioRxiv. 2020 Jan 1;2020.02.03.931766.

Zhou P, Yang X-L, Wang X-G, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. 2020 Mar 3;579(7798):270–3.

Yeo C, Kaushal S, Yeo D. Enteric involvement of coronaviruses: is faecal–oral transmission of SARS-CoV-2 possible? Lancet Gastroenterol Hepatol. 2020 Apr;5(4):335–7.

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Published

07-09-2020

Issue

Section

CORRESPONDENCE/CASE REPORTS - SPECIAL COVID19

How to Cite

1.
Nkeih C, Sisti G, Schiattarella A. Elevated transaminases in a COVID-19 positive patient at term of gestation: a case report: Covid19 and pregnancy. Acta Biomed. 2020;91(3):e2020002. doi:10.23750/abm.v91i3.9796