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Case report
Severe pre-eclampsia complicated by acute fatty liver disease of pregnancy, HELLP syndrome and acute kidney injury following SARS-CoV-2 infection
  1. Irshad Ahmed1,
  2. Nashwa Eltaweel2,
  3. Lina Antoun2 and
  4. Anoop Rehal2
  1. 1Obstetrics and Gynaecology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
  2. 2Obstetrics and Gynaecology, Birmingham Heartlands Hospital, Birmingham, West Midlands, UK
  1. Correspondence to Dr Irshad Ahmed; irshad.ahmed{at}


The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has presented many diagnostic challenges and uncertainties. Little is known about common pathologies complicating pregnancy and how their behaviour is modified by the presence of SARS-CoV-2. Pregnancy itself can alter the body’s response to viral infection, which can cause more severe symptoms. We report the first case of a patient affected with sudden-onset severe pre-eclampsia complicated by acute fatty liver disease of pregnancy, HELLP (haemolysis, elevated liver enzymes and low platelet) syndrome and acute kidney injury following SARS-CoV-2 infection. Although an initial diagnostic dilemma, a multidisciplinary team approach was required to ensure a favourable outcome for both the mother and the baby. Our case report highlights the need for health professionals caring for pregnant women to be aware of the complex interplay between SARS-CoV-2 infection and hypertensive disorders of pregnancy.

  • hypertension
  • liver disease
  • haematology (incl blood transfusion)
  • obstetrics and gynaecology
  • pregnancy

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  • Contributors IA analysed the data and wrote the paper. NE, LA and AR collected and analysed the data.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.