Acute Hepatitis in Children: Still need time for more studies even not related to COVID vaccine

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Acute Hepatitis in Children: Still need time for more studies even not related to COVID vaccine

Acute Hepatitis of Unknown Cause in Children: Still need time for more studies even not related to COVID vaccine.

A lot of news in the past two days is talking about unexplained hepatitis in children.

The etiology of these children is unknown, and the medical investigations are still in the preliminary stages, and there are only some speculations at present.

You can just wait and see, there is no need to pay too much attention to various rumors on the Internet.

Acute Hepatitis in Children: Still need time for more studies even not related to COVID vaccine

The whole thing is probably like this, first of all, there were multiple cases of acute hepatitis of unknown cause in children in the United Kingdom – the known hepatitis viruses of ABDBU were excluded in these cases.

Similar cases were subsequently discovered in other countries. As of April 21, the cumulative number of global cases reported was 169, distributed in 11 countries – 9 European countries plus the United States and Israel.

Many of these cases are very serious, and there has been one death. This also prompted the WHO, CDC, and the British health department to start investigations in a short period of time.

We think it is particularly important to stress that these investigations on acute hepatitis have just begun, and any assertions that are definitely caused by a certain cause can be ignored at this stage .

Since we are in the midst of a Covid-19 pandemic, some people who see any anomaly will worry if it is due to vaccines or Covid-19.

Among them, the relationship between the COVID-19 vaccine and this unknown hepatitis can be basically ruled out – the vast majority of children who are unfortunately sick have not been vaccinated against the COVID-19 vaccine.

Of the 169 cases reported, the youngest was 1 month old and the oldest was 16 years old. The vaccination of children in Europe and the United States started relatively late, and the progress was very slow.

For example, the United Kingdom only started allowing children under 12 to receive the COVID-19 vaccine in February this year.

Although the United States approved the COVID-19 vaccine for 5-11 years old last year, the vaccination rate is extremely low.

As of April 20, only 35% of children have received at least one vaccine [1]. The 9 cases in the United States are from Alabama, which is the place with the lowest vaccination rate in the United States [2].

Since the vast majority of children have not been vaccinated against the COVID-19, the association can be ruled out, and there is no need to worry about the unsafe vaccine .

Presumably because acute hepatitis in children has attracted widespread attention, and vaccines have recently been circulating on the Internet to cause hepatitis, for example, a paper in the Journal of Hepatology.

The paper describes the case of a 52-year-old man who developed autoimmune hepatitis after receiving the mRNA vaccine [3].

It should be noted that this is only a case. Although it cannot be ruled out that the immune response induced by the vaccine is wrong in extremely rare cases, resulting in such autoimmune diseases, but the COVID-19 vaccine is currently being tracked in large quantities. From the overall population, no autoimmunity has been increased . incidence of disease .

In fact, I found another case description published last year in the Journal of Autoimmunity of a woman who developed autoimmune hepatitis after vaccination [4].

Interestingly, the woman’s autoimmune hepatitis was caused by abnormal B cells and the production of autoimmune antibodies, while the case of the man who was turned crazy was characterized by abnormal T cells.

From the rarity of such cases and the differences in mechanism, it can be speculated that even if it is related to vaccination (it is difficult to clarify the cause and effect of individual cases), it should be accompanied by incidental events caused by various other factors (such as the individual’s special genetic background, etc.) have universality.

In particular, it should be emphasized that the above cases are all autoimmune hepatitis, and the human immune system makes a mistake and starts to attack the liver.

Not to be confused by some anti-vaccine people, unlike acute hepatitis in children that is emerging now. What’s more, most of the unfortunately sick children are not vaccinated at all!

In addition to vaccines, another concern is probably the COVID-19 infection. From the current cases, only a small number of COVID-19 infections have been detected, and it seems difficult to explain.

Moreover, after the COVID-19 infection, various disease manifestations, from thrombosis to myocarditis, have all kinds, but hepatitis has not been reported too much.

Taking into account the global medical community’s attention to the clinical manifestations of the COVID-19 in the past two years, although the virus may still have some surprises, it is really unlikely that acute hepatitis will be completely missed in more than two years.

Some people may be wondering if it’s because of a particular mutant – many people like to pay attention to whether a certain mutant has special symptoms. Let me pour cold water on this, no matter how many mutant strains mutate, it will still be a new coronavirus.

At present, the main mutations of the mutant strains are in the S protein, especially the S1 subunit of the S protein, and most of the mutations in Omicron are there.

The S protein is where the virus binds to the human ACE2 receptor, so mutations on it may alter the virus’ ability to spread (Delta’s S protein mutation binds better to ACE2 resulting in greater infectivity) or the degree of immune escape – S The protein is also where the antibody recognizes and blocks the invasion of the virus.

A large number of mutations in Omicron on the S protein lead to severe immune escape, which greatly reduces the ability of vaccines and past infections to prevent infection.

However, the mutation of the S protein did not subvert the pathogenic mode and main clinical manifestations of the COVID-19. We are seeing a reduction in lung invasion with Omicron, and we also see that Omicron causes a lower percentage of olfactory and taste dysfunction compared to Delta.

But these changes are all fluctuating proportions in the various clinical manifestations of the known COVID-19, not a completely different disease.

Therefore, the likelihood of a mutation in SARS-CoV-2 causing these rare hepatitiss is also low. Those marketing because of the unknown superpower of XX mutation can be ignored directly .

The now more supported hypothesis is that of adenoviruses . Adenovirus type 41 was detected in many children. However, this is a very common adenovirus that has never been associated with liver loss before.

Some scientists speculate that due to the impact of the epidemic in the past two years, children have less contact with the outside world and less opportunities to come into contact with various microorganisms.

Now that countries are opening up, common and harmless pathogens have become the first time for some children. Dangerous elements encountered may cause more serious consequences.

Of course, this is just a hypothesis and more research is needed to confirm it . And one of the reasons the hypothesis is now more supported is that the vast majority of known cases are from the UK (116).

Research in the UK has shown that local adenovirus infections fell sharply after the outbreak of the COVID-19 due to reduced human-to-human contact, and began to climb sharply last year as society reopened.

But is this a related cause, or just an accident? There must be more research to confirm. Also, don’t worry about adenovirus vaccines.

The COVID-19 vaccine uses a replication-defective recombinant adenovirus, which does not replicate in the human body and invade different organs like ordinary adenoviruses.

The pathogenic risk of common adenoviruses does not correspond to recombinant adenoviruses used in vaccines.

Finally, everyone should have reasonable expectations for the progress of the cause investigation . When a type of disease suddenly appears, it is not easy to identify the causative agent.

Taking today’s acute hepatitis in children as an example, the current clues are only concentrated in children, and then the symptoms are hepatitis.

In fact, there are so many cases in different countries, are they all caused by the same reason? Even, do these rare hepatitiss already exist, but they have not been paid attention to before? We need to give researchers more time to find clues.

Be mentally prepared for the number of cases of this type of hepatitis. We may see more cases in the coming period – with targeted screening recommendations from the WHO and others, many doctors will be more careful to identify potential cases, which means that case reports will certainly increase .

This does not necessarily mean that this type of acute hepatitis is common, but the researchers wanted to try not to miss the underlying pathology, and to fully analyze the possible etiology. Serious illness in children is a real worry for many, but don’t forget that it’s still a very rare disease and there’s no need to panic.

References:
https://www.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/children-and-covid-19-vaccination-trends/
https://www.science.org/content/article/mysterious-hepatitis-outbreak-sickens-young-children-europe-cdc-probes-cases-alabama
https://www.journal-of-hepatology.eu/article/S0168-8278(22)00234-3/fulltext

Acute Hepatitis in Children: Still need time for more studies even not related to COVID vaccine

(source:internet, reference only)

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