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COVID-19 and Hepatitis a Coinfection: A Case Report

Received: 5 January 2023     Accepted: 13 July 2023     Published: 24 July 2023
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Abstract

Elevated levels of liver enzymes have been identified as a common manifestation of coronavirus infection. However, it is essential to recognize that abnormal liver enzyme elevations in COVID-19 patients can also be attributed to acute hepatitis. This case report presents a clinical scenario involving a 61-year-old female patient who exhibited typical symptoms of COVID-19, including fever, nausea, anorexia, and abdominal pain. Initially, the suspicion was solely focused on COVID-19 infection. Nevertheless, subsequent investigation utilizing the acute hepatitis panel examination unveiled positive reactivity to HAV IgM, indicating a concomitant Hepatitis A virus coinfection. Throughout the course of hospitalization, the patient's clinical condition exhibited gradual improvement, leading to her discharge with an oxygen saturation level (Spo2%) exceeding 90%. Follow-up examinations conducted in the outpatient setting demonstrated the restoration of normal liver enzyme levels. This case serves as an exemplification of hepatitis coinfections, underscoring the diagnostic challenges associated with distinguishing between these two infectious conditions. It highlights the paramount importance of accurate diagnosis, preventive strategies, and optimal management approaches to effectively address such complex comorbidities. By recognizing the significance of precise diagnosis, comprehensive prevention, and appropriate management, healthcare professionals can navigate COVID-19 and hepatitis coinfections more effectively. This case report serves as a valuable reminder of the multifaceted nature of viral infections and underscores the need for a holistic approach to patient care when encountering overlapping symptomatology.

Published in International Journal of Medical Case Reports (Volume 2, Issue 3)
DOI 10.11648/j.ijmcr.20230203.11
Page(s) 16-19
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2023. Published by Science Publishing Group

Keywords

Co-infection, Coronavirus, COVID-19, Hepatitis, Liver

References
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[2] Kabaçam G, Wahlin S, Efe CJLI. Autoimmune hepatitis triggered by COVID-19: a report of two cases. 2021; 41 (10): 2527.
[3] Behzad S, Aghaghazvini L, Radmard AR, Gholamrezanezhad AJCi. Extrapulmonary manifestations of COVID-19: radiologic and clinical overview. 2020; 66: 35-41.
[4] Antala S, Diamond T, Kociolek LK, Shah AA, Chapin CAJJopg, nutrition. Severe Hepatitis in Pediatric COVID-19. 2022.
[5] Cascella M, Rajnik M, Aleem A, Dulebohn SC, Di Napoli RJS. Features, evaluation, and treatment of coronavirus (COVID-19). 2022.
[6] Sarkesh A, Sorkhabi AD, Sheykhsaran E, Alinezhad F, Mohammadzadeh N, Hemmat N, et al. Extrapulmonary clinical manifestations in COVID-19 patients. 2020; 103 (5): 1783.
[7] Azer SAJNM, Infections N. COVID-19: pathophysiology, diagnosis, complications and investigational therapeutics. 2020; 37: 100738.
[8] Wu Z-h, Yang DlJEJoMR. A meta-analysis of the impact of COVID-19 on liver dysfunction. 2020; 25 (1): 1-9.
[9] Dehghani S, Teimouri AJCCR. Severe Acute Hepatitis in a COVID-19 patient: A Case Report. 2021; 9 (10): e04869.
[10] Davern TJ, Chalasani N, Fontana RJ, Hayashi PH, Protiva P, Kleiner DE, et al. Acute hepatitis E infection accounts for some cases of suspected drug-induced liver injury. 2011; 141 (5): 1665-72. e9.
[11] Akerele IO, Nnabuchi CV, Oreh AC. Coronavirus disease (COVID-19) and acute nonicteric hepatitis: A case report from Asokoro, Nigeria. Journal of Family & Community Medicine. 2021 Jan; 28 (1): 59.
[12] Villar LM, de Paula VS, Pinto LC, Marques BC, da Costa VD, da Silva LL, Santos AC, do Nascimento GP, Miguel JC, da Fonseca Mendonça AC, Motta FC. Clinical and laboratory characteristics of hepatitis C and COVID-19 coinfection: Prolonged RNA shedding in nonhospitalized case. Clinical Case Reports. 2021 Aug; 9 (8).
[13] Ali E, Ziglam H, Kohla S, Ahmed M, Yassin M. A case of fulminant liver failure in a 24-year-old man with coinfection with hepatitis B virus and SARS-CoV-2. The American journal of case reports. 2020; 21: e925932-1.
[14] Nair S. COVID-19 pneumonia and dengue fever coinfection in an individual from Southeast Asia. Cureus. 2021 Oct 17; 13 (10).
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Cite This Article
  • APA Style

    Ali Mehri, Sepideh Hasanzadeh, Kiarash Ghazvini, Mahnaz Mozdurian. (2023). COVID-19 and Hepatitis a Coinfection: A Case Report. International Journal of Medical Case Reports, 2(3), 16-19. https://doi.org/10.11648/j.ijmcr.20230203.11

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    ACS Style

    Ali Mehri; Sepideh Hasanzadeh; Kiarash Ghazvini; Mahnaz Mozdurian. COVID-19 and Hepatitis a Coinfection: A Case Report. Int. J. Med. Case Rep. 2023, 2(3), 16-19. doi: 10.11648/j.ijmcr.20230203.11

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    AMA Style

    Ali Mehri, Sepideh Hasanzadeh, Kiarash Ghazvini, Mahnaz Mozdurian. COVID-19 and Hepatitis a Coinfection: A Case Report. Int J Med Case Rep. 2023;2(3):16-19. doi: 10.11648/j.ijmcr.20230203.11

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  • @article{10.11648/j.ijmcr.20230203.11,
      author = {Ali Mehri and Sepideh Hasanzadeh and Kiarash Ghazvini and Mahnaz Mozdurian},
      title = {COVID-19 and Hepatitis a Coinfection: A Case Report},
      journal = {International Journal of Medical Case Reports},
      volume = {2},
      number = {3},
      pages = {16-19},
      doi = {10.11648/j.ijmcr.20230203.11},
      url = {https://doi.org/10.11648/j.ijmcr.20230203.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijmcr.20230203.11},
      abstract = {Elevated levels of liver enzymes have been identified as a common manifestation of coronavirus infection. However, it is essential to recognize that abnormal liver enzyme elevations in COVID-19 patients can also be attributed to acute hepatitis. This case report presents a clinical scenario involving a 61-year-old female patient who exhibited typical symptoms of COVID-19, including fever, nausea, anorexia, and abdominal pain. Initially, the suspicion was solely focused on COVID-19 infection. Nevertheless, subsequent investigation utilizing the acute hepatitis panel examination unveiled positive reactivity to HAV IgM, indicating a concomitant Hepatitis A virus coinfection. Throughout the course of hospitalization, the patient's clinical condition exhibited gradual improvement, leading to her discharge with an oxygen saturation level (Spo2%) exceeding 90%. Follow-up examinations conducted in the outpatient setting demonstrated the restoration of normal liver enzyme levels. This case serves as an exemplification of hepatitis coinfections, underscoring the diagnostic challenges associated with distinguishing between these two infectious conditions. It highlights the paramount importance of accurate diagnosis, preventive strategies, and optimal management approaches to effectively address such complex comorbidities. By recognizing the significance of precise diagnosis, comprehensive prevention, and appropriate management, healthcare professionals can navigate COVID-19 and hepatitis coinfections more effectively. This case report serves as a valuable reminder of the multifaceted nature of viral infections and underscores the need for a holistic approach to patient care when encountering overlapping symptomatology.},
     year = {2023}
    }
    

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  • TY  - JOUR
    T1  - COVID-19 and Hepatitis a Coinfection: A Case Report
    AU  - Ali Mehri
    AU  - Sepideh Hasanzadeh
    AU  - Kiarash Ghazvini
    AU  - Mahnaz Mozdurian
    Y1  - 2023/07/24
    PY  - 2023
    N1  - https://doi.org/10.11648/j.ijmcr.20230203.11
    DO  - 10.11648/j.ijmcr.20230203.11
    T2  - International Journal of Medical Case Reports
    JF  - International Journal of Medical Case Reports
    JO  - International Journal of Medical Case Reports
    SP  - 16
    EP  - 19
    PB  - Science Publishing Group
    SN  - 2994-7049
    UR  - https://doi.org/10.11648/j.ijmcr.20230203.11
    AB  - Elevated levels of liver enzymes have been identified as a common manifestation of coronavirus infection. However, it is essential to recognize that abnormal liver enzyme elevations in COVID-19 patients can also be attributed to acute hepatitis. This case report presents a clinical scenario involving a 61-year-old female patient who exhibited typical symptoms of COVID-19, including fever, nausea, anorexia, and abdominal pain. Initially, the suspicion was solely focused on COVID-19 infection. Nevertheless, subsequent investigation utilizing the acute hepatitis panel examination unveiled positive reactivity to HAV IgM, indicating a concomitant Hepatitis A virus coinfection. Throughout the course of hospitalization, the patient's clinical condition exhibited gradual improvement, leading to her discharge with an oxygen saturation level (Spo2%) exceeding 90%. Follow-up examinations conducted in the outpatient setting demonstrated the restoration of normal liver enzyme levels. This case serves as an exemplification of hepatitis coinfections, underscoring the diagnostic challenges associated with distinguishing between these two infectious conditions. It highlights the paramount importance of accurate diagnosis, preventive strategies, and optimal management approaches to effectively address such complex comorbidities. By recognizing the significance of precise diagnosis, comprehensive prevention, and appropriate management, healthcare professionals can navigate COVID-19 and hepatitis coinfections more effectively. This case report serves as a valuable reminder of the multifaceted nature of viral infections and underscores the need for a holistic approach to patient care when encountering overlapping symptomatology.
    VL  - 2
    IS  - 3
    ER  - 

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Author Information
  • Endoscopic and Minimally Invasive Surgery Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran

  • Antimicrobial Resistance Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran

  • Antimicrobial Resistance Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran

  • Lung Diseases Research Centre, Mashhad University of Medical Science, Mashhad, Iran

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