Hepatic Decompensation Associated With COVID-19 in a Patient With Alcoholic Liver Cirrhosis: A Case Report

Coronavirus disease 2019 (COVID-19) presents a spectrum of severity, ranging from asymptomatic infection to life-threatening respiratory failure. Patients with comorbidities, such as alcoholic liver cirrhosis, are at increased risk for adverse outcomes, as COVID-19 may precipitate hepatic decompensation. We report the case of a 60-year-old man with a history of alcoholic liver cirrhosis who was admitted with fever, cough, diarrhea, and fatigue. COVID-19 was confirmed via polymerase chain reaction (PCR) testing. He was diagnosed with bilateral pneumonia and had elevated liver enzymes. Treatment included azithromycin, doxycycline, enoxaparin, and dexamethasone. The patient showed clinical improvement following 10 days of therapy and was subsequently discharged. Two months later, he developed gastrointestinal bleeding due to ruptured esophageal varices. Over the following months, his condition worsened progressively, marked by severe malnutrition, recurrent ascites, and the development of hepatorenal syndrome. Despite ongoing care, he died one year after the initial COVID-19 diagnosis. This case highlights alcoholic liver cirrhosis as an independent risk factor for COVID-19-related complications and mortality, underscoring the need for targeted acute management and long-term follow-up in this vulnerable population, an essential consideration for future infectious disease outbreaks.