{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T17:55:34Z","timestamp":1792691734499,"version":"4.5.0"},"reference-count":6,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2020,8,1]],"date-time":"2020-08-01T00:00:00Z","timestamp":1596240000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/bmj.com\/coronavirus\/usage"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,7,22]]},"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:p>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\u2019s 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.<\/jats:p>","DOI":"10.1136\/bcr-2020-237521","type":"journal-article","created":{"date-parts":[[2020,8,11]],"date-time":"2020-08-11T08:47:41Z","timestamp":1597135661000},"page":"e237521","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":25,"title":["Severe pre-eclampsia complicated by acute fatty liver disease of pregnancy, HELLP syndrome and acute kidney injury following SARS-CoV-2 infection"],"prefix":"10.1136","volume":"13","author":[{"given":"Irshad","family":"Ahmed","sequence":"first","affiliation":[{"name":"Obstetrics and Gynaecology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nashwa","family":"Eltaweel","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology, Birmingham Heartlands Hospital, Birmingham, West Midlands, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lina","family":"Antoun","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology, Birmingham Heartlands Hospital, Birmingham, West Midlands, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anoop","family":"Rehal","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology, Birmingham Heartlands Hospital, Birmingham, West Midlands, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,8,11]]},"reference":[{"key":"2025082801520148000_13.8.e237521.1","doi-asserted-by":"crossref","DOI":"10.1016\/j.ijantimicag.2020.106024","article-title":"Extra-respiratory manifestations of COVID-19","author":"Lai","year":"2020","journal-title":"Int J Antimicrob Agents"},{"key":"2025082801520148000_13.8.e237521.2","unstructured":"Royal College of obstetricians and gynaecologists (2020): coronavirus (SARS COV-2) infection in pregnancy version 8, 2020. Available: https:\/\/www.rcog.org.uk\/globalassets\/documents\/guidelines\/2020-04-17-coronavirus-covid-19-infection-in-pregnancy.pdf"},{"key":"2025082801520148000_13.8.e237521.3","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2008.148676"},{"key":"2025082801520148000_13.8.e237521.4","doi-asserted-by":"publisher","DOI":"10.1136\/gut.51.6.876"},{"key":"2025082801520148000_13.8.e237521.5","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1177\/1753495X17695173","article-title":"Presumed acute fatty liver of pregnancy following influenza a hepatitis","volume":"10","author":"Morton","year":"2017","journal-title":"Obstet Med"},{"key":"2025082801520148000_13.8.e237521.6","unstructured":"Mendoza M , Garc\u00eda-Ruiz I , Maiz N , et al . Severe COVID-19-induced preeclampsia-like syndrome: a prospective observational study. BJOG 2020."}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2020-237521","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T08:52:11Z","timestamp":1756371131000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2020-237521"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8]]},"references-count":6,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2020,8,11]]},"published-print":{"date-parts":[[2020,8]]}},"alternative-id":["10.1136\/bcr-2020-237521"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2020-237521","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,8]]}}}