Conjugated Hyperbilirubinemia in a Patient With COVID-19: A Case Report and Literature Review

Coronavirus disease 2019 (COVID-19) was first reported at the end of 2019 and soon evolved into a deadly pandemic of the century. It has a myriad of clinical presentations and is associated with significant mortality and morbidity. We report a case of a 49-year-old Hispanic man who presented to the emergency department with complaints of productive cough, shortness of breath, fever, and body aches for the past five days. On clinical examination, he was noted to have jaundice. Laboratory results revealed conjugated hyperbilirubinemia and elevated alkaline phosphatase. The patient tested positive for COVID-19 and appropriate treatment was initiated as per hospital protocols. All potential causes of hyperbilirubinemia were systematically excluded, including autoimmune, metabolic, hemolytic, septic, drug-induced, parasitic, and biliary etiologies. Hyperbilirubinemia improved with the treatment of COVID-19. All other causes of hyperbilirubinemia must be excluded in these individuals before attributing it to COVID-19. Further research is needed to understand the disease and to guide appropriate therapy.