{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:37:07Z","timestamp":1787020627038,"version":"build-2736575974"},"reference-count":13,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,9,5]],"date-time":"2021-09-05T00:00:00Z","timestamp":1630800000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,9,5]],"date-time":"2021-09-05T00:00:00Z","timestamp":1630800000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Deputy state parliamentary MG, Beatriz Cerqueira","award":["2071001135\/2020"],"award-info":[{"award-number":["2071001135\/2020"]}]},{"name":"FAPEMIG PPSUS","award":["APQ-00846-20"],"award-info":[{"award-number":["APQ-00846-20"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Virol J"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Covid-19 has the respiratory tract as the main target of infection, and patients present mainly dyspnea, pneumonia, dry cough, and fever. Nevertheless, organs outside the respiratory tract had been reported in recent studies, including the gastrointestinal tract and liver. The host innate immune system recognizes pathogen-associated molecular patterns (PAMPs) through their pattern recognition receptor (PRRs). Toll-like receptor 7 (TLR-7) is a pattern recognition receptor recognizing ssRNA (SARS-CoV-2 is an ssRNA). Polymorphisms are characterized by two or more alternative forms of a distinct phenotype in the same population. Polymorphisms in\n                      <jats:italic>tlrs<\/jats:italic>\n                      genes can negatively influence the immune response to infectious diseases. There are several references in the literature to non-synonymous single nucleotide (rs) polymorphisms related to several genes. Some of them are important for the innate immunity, as rs 179008 (\n                      <jats:italic>tlr-7<\/jats:italic>\n                      ), rs3775291 (\n                      <jats:italic>tlr3<\/jats:italic>\n                      ), rs8177374 (\n                      <jats:italic>tir domain-containing adaptor protein, tirap<\/jats:italic>\n                      ), rs1024611 (\n                      <jats:italic>monocyte chemoattractant protein-1, mcp-1<\/jats:italic>\n                      ) and rs61942233 (\n                      <jats:italic>2<\/jats:italic>\n                      \u2032\n                      <jats:italic>-5<\/jats:italic>\n                      \u2032\n                      <jats:italic>-oligoadenylate synthase-3, oas-3<\/jats:italic>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>\n                      We identified a 5-year-old-male child with gastrointestinal symptoms and fever presenting acholic stool and jaundice, who was positive for SARS-CoV-2 IgM, IgA, and IgG and presenting the Gln11Leu rs 179008 in\n                      <jats:italic>tlr-7<\/jats:italic>\n                      . The child presented high levels of aspartate aminotransferase, alanine aminotransferase, bilirubin, C-reactive protein, D-dimer, gamma-glutamyl transferase, alkaline phosphatase, and was negative for serological tests for hepatitis A, B, C, E, HIV 1 and 2, herpes virus, cytomegalovirus, Epstein\u2013Barr virus, and negative for RTqPCR for Influenza A and B, RSV and SARS-CoV-2. We also investigated other SNPs in the\n                      <jats:italic>tlr-3<\/jats:italic>\n                      (rs3775291)\n                      <jats:italic>, tirap<\/jats:italic>\n                      (rs8177374)\n                      <jats:italic>, mcp-1<\/jats:italic>\n                      (rs1024611)\n                      <jats:italic>,<\/jats:italic>\n                      and\n                      <jats:italic>oas-3<\/jats:italic>\n                      (rs61942233) genes, and no mutation was detected\n                      <jats:bold>.<\/jats:bold>\n                      After an interview with the child's caregivers, any possible accidental ingestion of drugs or hepatotoxic substances was ruled out.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      To our knowledge, this is the first report of a SARS-CoV-2 caused hepatitis in a male child that has the\n                      <jats:italic>tlr-7<\/jats:italic>\n                      Gln11Leu rs 179008, which could impair an efficient initial immune response. The knowledge of the patient's immune deficiency could improve the treatment to correct this deficiency with specific medications.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12985-021-01656-3","type":"journal-article","created":{"date-parts":[[2021,9,5]],"date-time":"2021-09-05T10:02:16Z","timestamp":1630836136000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Case report: hepatitis in a child infected with SARS-CoV-2 presenting toll-like receptor 7 Gln11Leu single nucleotide polymorphism"],"prefix":"10.1186","volume":"18","author":[{"given":"Nat\u00e1lia Lima","family":"Pessoa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aline Almeida","family":"Bentes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea Lucchesi","family":"de Carvalho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tha\u00eds B\u00e1rbara","family":"de Souza Silva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro Augusto","family":"Alves","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik Vinicius","family":"de Sousa Reis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tayse Andrade","family":"Rodrigues","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erna Geessien","family":"Kroon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4683-0176","authenticated-orcid":false,"given":"Marco Ant\u00f4nio","family":"Campos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,9,5]]},"reference":[{"key":"1656_CR1","doi-asserted-by":"publisher","first-page":"497","DOI":"10.1016\/S0140-6736(20)30183-5","volume":"395","author":"C Huang","year":"2020","unstructured":"Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. 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The patient's responsible written permission was obtained.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The patient's responsible written permission was obtained.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"TAR declares competing interests. She received a salary from Quibasa Qu\u00edmica B\u00e1sica (producer of immunological test kits, address Rua Teles Menezes 92, 31565-130 Belo Horizonte, MG, Brazil) (\n                      \n                      ).","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"180"}}