December 4, 2022

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Hepatitis in children with unknown etiology is more likely to be a sequelae of COVID-19

Hepatitis in children with unknown etiology is more likely to be a sequelae of COVID-19



 

New study: Hepatitis in children with unknown etiology is more likely to be a sequelae of COVID-19

 

A few days ago, researchers from Israel’s Schneider Children’s Medical Center, Belinson Hospital, Rambam Medical Center, and Tel Aviv University published a paper titled “Liver manifestations of chronic COVID-19 pneumonia in children” in the journal Pediatric Gastroenterology and Nutrition. 

The article analyzed the clinical manifestations and laboratory test results of 5 children with unexplained hepatitis received by Schneider Children’s Medical Center.

It is believed that the so-called “children’s hepatitis of unknown etiology” is more likely to be caused by new coronavirus infection, and adenovirus is not the culprit. The paper has been peer-reviewed.

 

Hepatitis in children with unknown etiology is more likely to be a sequelae of COVID-19

 


According to the article, all 5 patients were infected with the new coronavirus before they developed hepatitis symptoms:

  • Case 1 is a 3-month-old infant who developed acute liver failure and received liver transplantation 21 days after the new coronavirus test was positive. After admission, the new coronavirus and adenovirus tests were negative;
  • Case 2 is a 5-month-old infant who was hospitalized with fever, jaundice, and hepatomegaly. His condition deteriorated and he underwent liver transplantation. After admission, both new coronavirus and adenovirus were tested positive;
  • Case 3 is an 8-year-old boy who began to develop hepatitis symptoms such as abdominal pain, vomiting and jaundice 130 days after the positive test for the new coronavirus. After admission, the tests for the new coronavirus and adenovirus were negative;
  • Case 4 is also an 8-year-old boy. He began to develop hepatitis symptoms such as high fever, jaundice, and diarrhea 90 days after the new coronavirus test was positive. After admission, the new coronavirus and adenovirus tests were negative;
  • Case 5 was a 13-year-old boy who had symptoms such as weakness, diarrhea, and jaundice when he tested positive for the new coronavirus . Symptoms of vomiting, abdominal pain, jaundice, hepatomegaly, and liver damage occurred, and he tested positive for adenovirus.


The researchers found that the unexplained hepatitis manifested differently in infants and children, with two infants developing acute liver failure, while the other three children over the age of 8 presented predominantly with acute hepatitis and cholestasis.


In response to the hypothesis that adenovirus infection causes childhood hepatitis of unknown etiology , the researchers specifically analyzed liver biopsy samples from the above-mentioned patients.

The results did not find any adenovirus antigens, and there were no histological features of adenovirus hepatitis.

Therefore, “it is not considered that adenovirus Infection is the main culprit in hepatitis”.


The researchers pointed out that the new coronavirus can cause hepatitis in two ways. One is that the new coronavirus directly invades the liver through the abundant ACE2 receptors on bile duct cells, that is, “direct virus damage” .

The basis is that the above five patients are all asymptomatic or mild new coronavirus cases, which are unlikely to be caused by inflammatory storms.

Liver damage; the other is immune system dysregulation caused by 2019-nCoV infection, which is based on the emergence of a systemic inflammatory syndrome called secondary hemophagocytic lymphohistiocytosis (HLH) in case 2, and according to this Hypothetically, multiple patients improved after steroid treatment.


Although the number of cases involved in the paper is limited, one of the authors of the paper, Wisbard Zinman, a pediatric gastroenterologist at Schneider Children’s Medical Center, told Israeli media that a comprehensive examination found that all five children had previously Having been infected with the new coronavirus and not vaccinated, they then took in eight children with hepatitis of unknown etiology and could only identify a relationship to the new coronavirus infection.

The current link between this group of severe hepatitis cases and Covid-19 led them to conclude that the situation was the result of “long-term Covid-19.” The new coronavirus is more likely to be the main cause of childhood hepatitis of unknown etiology.

 

 

 

 

Hepatitis in children with unknown etiology is more likely to be a sequelae of COVID-19

(source:internet, reference only)


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