Case Report: Hyperbilirubinemia in Gilbert Syndrome Attenuates Covid-19-Induced Metabolic Disturbances

Hayder M Al-Kuraishy; Ali I Al-Gareeb; Saleh M Abdullah; Natália Cruz-Martins; Gaber El-Saber Batiha

doi:10.3389/fcvm.2021.642181

Case Report: Hyperbilirubinemia in Gilbert Syndrome Attenuates Covid-19-Induced Metabolic Disturbances

Front Cardiovasc Med. 2021 Feb 17:8:642181. doi: 10.3389/fcvm.2021.642181. eCollection 2021.

Authors

Hayder M Al-Kuraishy¹, Ali I Al-Gareeb¹, Saleh M Abdullah², Natália Cruz-Martins^{3

4

5}, Gaber El-Saber Batiha⁶

Affiliations

¹ Department of Clinical Pharmacology and Medicine, College of Medicine, Al-Mustansiriya University, Baghdad, Iraq.
² Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia.
³ Faculty of Medicine, University of Porto, Porto, Portugal.
⁴ Department of Metabolism, Nutrition and Endocrinology, Institute for Research and Innovation in Health (i3S), University of Porto, Porto, Portugal.
⁵ Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal.
⁶ Department of Pharmacology and Therapeutics, Faculty of Veterinary Medicine, Damanhour University, Damanhour, Egypt.

Abstract

Gilbert syndrome (GS) is a liver disorder characterized by non-hemolytic unconjugated hyperbilirubinemia. On the other hand, Coronavirus disease 2019 (Covid-19) is a recent viral infectious disease presented as clusters of pneumonia, triggered by the severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2). Little is known on the association between SARS-CoV-2 and GS, despite different studies have recently stated a link between hyperbilirubinemia and SARS-CoV-2 severity. In this case-report study we described a 47-year-old man, a known case of GS since the age of 4, presented to the emergency department with fever (39.8°C), dry cough, dyspnea, headache, myalgia, sweating and jaundice diagnosed with Covid-19-induced pneumonia. Interestingly, GS patient exhibited a rapid clinical recovery and short hospital stay compared to other SARS-CoV-2 positive patient, seeming that hyperbilirubinemia may exert a protective effect of against Covid-19 induced-cardiometabolic disturbances. Data obtained here underlines that the higher resistance against Covid-19 evidenced by the GS patient seems to be due to the antioxidant, anti-inflammatory, and antiviral effects of unconjugated bilirubin.

Keywords: COVID-19; SARS-CoV-2; gilbert syndrome; hyperbilirubinemia; metabolic disease.

Publication types

Case Reports