Elevated transaminases in a COVID-19 positive patient at term of gestation: a case report

Background: The coronavirus disease 2019 (COVID-19) pandemic is caused by the severe acute respiratory syndrome 2 virus (SARS-CoV-2) and it is spreading worldwide with an alarming high transmis-sion rate. SARS-CoV-2 usually attacks the lungs causing a wide range of symptoms ranging from mild dysp-nea to severe shortness of breath requiring intubation. Elevation of liver transaminases in the patients’ sera has been described in up to 53% of the COVID-19 positive patients. The underlying pathogenic mechanisms of the virus on the liver cells are unclear and only few hypotheses are currently available. Data on COVID-19 in pregnant women are lacking and the management of COVID-19 pregnant women is challenging. An el-evation of the transaminases during pregnancies infected by SARS-CoV-2 has never been described before. Methods: Here we presented the case of a 29 years-old patient at 38 weeks of gestation COVID-19 positive with elevated transaminases. Results:The patient showed a progressive decrease of transaminases after the delivery of the fetus. We provided details about the daily transaminases trend, the therapy used and the ma-ternal/neonatal outcomes. Conclusions: We speculate that in our case the delivery of the fetus contributed to the normalization of the liver enzymes. In patients affected by COVID-19, at term of gestation, with elevated transaminases, delivery of the fetus is an appealing option. If confirmed by larger studies, our proposed man-agement might be incorporated in the obstetrical management guidelines for COVID-19 positive patients.(www.actabiomedica.it)