CC BY-NC-ND 4.0 · AJP Rep 2023; 13(04): e78-e81
DOI: 10.1055/s-0043-1777099
Case Report

A Case of Significant Transaminitis with Liver Biopsy in a Pregnant Patient with COVID-19

1   Department of Obstetrics and Gynecology, University of California, Irvine, Orange, California
Anna Galyean
2   Department of Obstetrics and Gynecology, Southern California Permanente Medical Group, Pasadena, California
Kelvin Nguyen
3   Department of Gastroenterology, Southern California Permanente Medical Group, Pasadena, California
Najeeb Alshak
4   Department of Pathology, Southern California Permanente Medical Group, Pasadena, California
Elizabeth Blumenthal
2   Department of Obstetrics and Gynecology, Southern California Permanente Medical Group, Pasadena, California
› Author Affiliations


Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2, has led to a global health crisis. The virus can cause varying severity of liver injury, but the mechanism has not yet been elucidated, especially in pregnancy.

We present a morbidly obese 30-year-old woman with COVID-19 at 28 weeks' gestation complicated by significant transaminitis with peak liver enzymes levels of 501/1,313 (aspartate aminotransferase/alanine aminotransferase). Liver biopsy showed reactive changes consistent with medication effect and mild steatosis.

Significant transaminitis has been found in both pregnant and nonpregnant patients with COVID-19. Our case demonstrates the multifactorial nature of liver injury in COVID-19 patients including mild underlying liver steatosis combined with possible viral potentiation of medication effect.

Publication History

Received: 23 November 2020

Accepted: 30 August 2023

Article published online:
28 November 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (

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