Elevated liver enzimes induced by COVID-19 in pregnancy Elevación de enzimas hepáticas inducida por COVID-19 en embarazada

Abstract Introduction: Approximately 3-5% of women present alterations of hepatic enzymes during pregnancy Under the new circumstances that the world is facing with the SARS-COV2 pandemic, a new etiology for hepatic enzyme alterations has risen The severe acute respiratory syndrome that the novel coronavirus causes is responsible for hepatic enzyme alterations in 2 to 11% of the sick population that did not have a previous underlying hepatic condition Furthermore, hepatic enzyme alterations in pregnant women infected with SARS-COV2 presents in up to 30% of the cases An infrequent presentation of SARS-COV2 is presented as our clinical case Clinical Case: A 36-year-old patient with a 20+6 week pregnancy presents abdominal pain, jaundice and choluria General blood workup shows elevated transaminases The abdominal ultrasound revealed a thin bile duct Acute and chronic hepatitis etiologies were discarded Finally, a PCR of COVID-19 was solicited, which turned out to be positive Conclusion: After an exhaustive study to determine the etiology of the elevated transaminases, the hepatic alterations were attributed to SARS-COV2 infection A conservative management was adopted, with outpatient follow-up with liver testing every two weeks The patient progresses with a stable steady decline in hepatic enzyme levels, and one-month post hospital discharge, her transaminases had reached normal values Based on this clinical case, after ruling out frequent etiologies for elevated transaminases during pregnancy, it seems reasonable to request a PCR for COVID-19, since it could be a rare presentation of SARS-CoV-2