A Case of Hepatitis: Post - Acute Sequelae of Asymptomatic Covid-19 Infection

ABSTRACT

A 25-year-old female presented to our institute with complaints of dark urine nausea and abdominal pain. Further evaluation revealed abnormal liver function tests. Imaging studies revealed that the patient was suffering from acute hepatitis and acalculous cholecystitis. The patient also gave history that she had recovered from Covid 19 infection a month back. On Further testing she was found to have a positive EBV serology result and a reactive IgG for Cytomegalovirus. Liver biopsy was suggestive of Acute hepatitis with feature of submissive hepatic necrosis. The authors believe that this is one of the first reported cases of acute hepatitis & acalculous cholecystitis presenting as a sequela of Covid 19 or activation of cytomegalovirus or EBV hepatitis. Clinicians should be aware in this era of COVID-19 infection that acute icteric hepatitis may be the virus-related manifestation after the resolution of initial pulmonary symptoms or may precipitate underlying quiescent disease.