COVID-19 is a risk factor for severe liver damage for patients with intrahepatic cholestasis of pregnancy: a case report

Background: Patients with intrahepatic cholestasis of pregnancy (ICP) may present with slight liver damage. In the global outbreak, the number of pregnant women infected with coronavirus disease 2019 (COVID-19) is increasing. For the pregnant patients with ICP, COVID-19 may cause severe liver damage. Case presentation: A 31-year-old pregnant woman was admitted with fever and respiratory symptoms to Tongji Hospital in Wuhan amid the outbreak of COVID-19. Her chest CT scan showed an infection with viral pneumonia as multiple ground glass opacities in both lungs were spotted. Laboratory tests revealed increased white blood cell (WBC) count and decreased lymphocyte count. The levels of serum total bile acid (TBA) were highly elvated. So were the indices of liver function, including alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), direct bilirubin (DBIL), alkaline phosphatase (AKP), 𝛄-glutamyltranspeptidase (𝛄-GT), and lactate dehydrogenase (LDH). The patient was later diagnosed of COVID-19 with comorbid ICP, presenting severe liver damage. Through timely termination of pregnancy and effective treatments, the prognoses of the patient and the fetus were well improved. Conclusions: : This case highlights that COVID-19 may be a risk factor of severe liver damage for patients with ICP.Timely termination of pregnancy and effective symptomatic treatments are helpful to improve the progonosis.