A Rare Cause of Acute Liver Failure

Question: A 42-year-old man presented with fever, dyspnea malaise, and paresthesia. The patient's medical history was notable for type 2 diabetes mellitus, hypertension, dyslipidemia, and coronary artery bypass surgery ten months before presentation. Three days before this presentation, he developed fever and malaise and tested positive for Covid-19. He was prescribed a 5-day course of nirmatrelvir-ritonavir (Paxlovid; Pfizer). Home medications included aspirin, atorvastatin, losartan, metformin, and metoprolol.