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    COVID-19:
    a fatal case of acute liver failure associated with SARS-CoV-2 infection in pre-existing liver cirrhosis (2021)

    Art
    Zeitschriftenartikel / wissenschaftlicher Beitrag
    Autoren
    Ihlow, Jana
    Seelhoff, Alexander
    Corman, Victor M.
    Gruber, Achim D. (WE 12)
    Dökel, Simon (WE 12)
    Meinhardt, Jenny
    Radbruch, Helena
    Späth-Schwalbe, Ernst
    Elezkurtaj, Sefer
    Horst, David
    Herbst, Hermann
    Quelle
    BMC infectious diseases
    Bandzählung: 21
    Heftzählung: 1
    Seiten: Article number: 901
    ISSN: 1471-2334
    Sprache
    Englisch
    Verweise
    URL (Volltext): https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-021-06605-7
    DOI: 10.1186/s12879-021-06605-7
    Pubmed: 34479499
    Kontakt
    Institut für Tierpathologie

    Robert-von-Ostertag-Str. 15
    14163 Berlin
    +49 30 838 62450
    pathologie@vetmed.fu-berlin.de

    Abstract / Zusammenfassung

    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.