Coronavirus disease 2019–associated liver injury in pregnancy: A case report

Abstract

Liver injury is an increasingly recognized extrapulmonary manifestation of coronavirus disease 2019 (COVID-19), particularly during pregnancy due to overlapping physiological and pathological changes. A 26-year-old primigravida at 24 +4 weeks of gestation presented with fever, chills, weakness, and sore throat, who was later confirmed to be severe acute respiratory syndrome coronavirus 2–positive. Laboratory tests revealed lymphopenia, elevated liver enzymes, low platelet count, increased D-dimer level, high total bilirubin level, and elevated lactate dehydrogenase levels. After thorough evaluation, these findings were attributed to COVID-19–associated liver injury. The patient was provided with supportive care and symptomatic treatment, resulting in gradual normalization of liver function. She was discharged at 26 weeks of gestation in stable condition. This case highlights the importance of considering COVID-19–associated liver injury in pregnant patients presenting with hepatic dysfunction, where prompt recognition and conservative management can help achieve favorable maternal outcomes.