A 6-year, 2-month-old boy presented with a history of fever and abdominal pain for 5 days. Fever at onset was moderate grade, intermittent, and progressed to continuous high grade. There was no significant history and had normal birth and development. His weight was 19 kg (between -1 SD and median) and height was 112 cm (between -1 SD and median).On clinical examination, the patient was conscious, oriented, febrile (102°F) with tachycardia and tachypnea proportionate to fever. SpO 2 was 97% on room air. Blood pressure was 100/64 mmHg (between 50 th and 90 th centile). He had icterus over bulbar conjunctiva. Abdominal examination on superficial palpation revealed right hypochondriac tenderness and deep palpation revealed hepatomegaly (4 cm) below the right costal margin with smooth surface, soft in consistency with round margins and liver span of 10 cm was found. There were no other signs of liver cell failure and other systemic examination was normal. With significant family history of both parents being diagnosed with COVID-19 infection and high-grade fever, COVID-19 RT-PCR was sent which was positive.On further investigation, liver function tests (LFTs) revealed serum glutamic-oxaloacetic transaminase (SGOT) of 5046 (15-50 IU/L) and serum glutamic-pyruvic transaminase (SGPT) of 3573 (5-45 IU/L). Total serum bilirubin