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25 September 2020 : Case report  Poland

Nosocomial COVID-19 Infection and Severe COVID-19 Pneumonia in Patients Hospitalized for Alcoholic Liver Disease: A Case Report

Rare coexistence of disease or pathology

Hanna Wiśniewska1ABDEF, Miłosz Skowron2ABDEF, Dorota Bander1AB, Monika Hornung1AB, Krzysztof Jurczyk1AB, Ewa Karpińska1AB, Łukasz Laurans1AB, Łukasz Socha1AB, Zenon Czajkowski2AB, Marta Wawrzynowicz - Syczewska1ABEFG*

DOI: 10.12659/AJCR.927452

Am J Case Rep 2020; 21:e927452

Abstract

BACKGROUND: COVID-19 is an infectious disease caused by SARS-CoV-2. It has spread rapidly through the world, endangering human life. The main target of COVID-19 is the lungs; however, it can involve other organs, including the liver. Patients with severe COVID-19 have an increased incidence of abnormal liver function, and patients with liver disorders are considered to be at a higher risk of severe COVID-19 infection. The mechanism of liver injury reported in 14% to 53% of COVID-19 patients is poorly recognized and several possibilities need to be considered (cytokine storm, direct viral action, hypoxia). The incidence of underlying liver comorbidities in patients with a COVID-19 infection ranges from 1% to 11%.

CASE REPORT: This is a report of 2 nosocomial COVID-19 infections and severe COVID-19 pneumonia in 2 patients who were hospitalized during treatment for alcoholic liver disease (ALD). Case 1 and case 2 were a 31-year-old woman and a 40-year-old woman, respectively, with decompensated ALD and symptoms of the COVID-19 infection. Both patients were transferred from another hospital to our hospital after confirmation of COVID-19 during their hospitalization. The course of the infection progressed rapidly in both patients with the development of multiple-organ failure and death over a short period.

CONCLUSIONS: There are no clear recommendations on the management of ALD in the COVID-19 pandemic. Alcoholic hepatitis may be a risk factor for severe COVID-19 and a poor outcome. A high percentage of nosocomial COVID-19 infections are observed; therefore, special precautions should be taken to minimize the risk of COVID-19 exposure.

Keywords: SARS Virus, COVID-19, Hepatitis, Alcoholic, Liver Diseases, Alcoholic, Cross Infection, case reports

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923