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We herein report a case involving a 39-year-old woman with a 23-day history of yellow skin and urine. Using the revised original scoring system of the International AIH Group, we definitively diagnosed the patient with acute severe AIH (AS-AIH). She began treatment with 80\u2009mg\/day intravenous methylprednisolone, which was gradually reduced and followed by eventual transition to oral methylprednisolone. The patient finally achieved a biochemical response after 30 days of therapy, and liver transplantation was avoided. Clinicians should be aware that the onset of AS-AIH after SARS-CoV-2 infection differs from the onset of conventional AIH with respect to its clinical and pathological features. Early diagnosis and timely glucocorticoid treatment are crucial in improving outcomes.<\/jats:p>","DOI":"10.1177\/03000605241233450","type":"journal-article","created":{"date-parts":[[2024,3,19]],"date-time":"2024-03-19T10:10:02Z","timestamp":1710843002000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Onset of acute severe autoimmune hepatitis after severe acute respiratory syndrome coronavirus 2 infection: a case report"],"prefix":"10.1177","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8607-4999","authenticated-orcid":false,"given":"Yi-Jun","family":"Zhou","sequence":"first","affiliation":[{"name":"Department of Hepatology, Affiliated Hangzhou Xixi Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiao-Fei","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of 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