Health officials have received reports from hundreds of children in 33 countries, including the United States, diagnosed with acute hepatitis of unknown origin that is clinically more severe than previous similar cases and with a higher proportion of young patients with liver failure.
The World Health Organization (WHO) said in a statement on May 27 that it had received reports of 650 probable cases of acute hepatitis of unknown origin in children between April 5 and May 26, and the reports came as researchers theorized about a possible link to COVID. -19, the disease caused by the virus like the PCC (Chinese Communist Party).
“The etiology of this severe acute hepatitis remains unknown and is being investigated,” the health agency said. “Cases are clinically more severe and a higher proportion develop acute liver failure compared to previous reports of acute hepatitis of unknown etiology in children.”
As of May 26, an additional 99 cases were pending classification, with the potential to bring the total number of cases to 749, if confirmed.
Nearly 60 per cent of reported cases were in Europe, with 222 in the UK alone. Of the 240 cases reported in the Americas in total, 216 cases were reported in the United States.
The flag of the World Health Organization (WHO) at its headquarters in Geneva on March 5, 2021. (Fabrice Coffrini / AFP via Getty Images)
It comes after the Centers for Disease Control and Prevention (CDC) in late April issued a nationwide health alert on a group of nine children in Alabama identified with hepatitis and adenovirus infection, with no known cause.
The children were between one and six years old, all of them previously healthy, with five of them admitted to hospital with a severe liver injury, including some with acute liver failure.
“Hepatitis A, hepatitis B and hepatitis C viruses were ruled out,” the CDC said, adding that all children tested positive for adenovirus.
The agency asked doctors to be alert for symptoms and to report any suspected case of hepatitis of unknown origin to the local health department. Typical symptoms include dark urine, clear stools, vomiting, and jaundice.
Link to COVID-19?
The CDC later issued a report saying none of the Alabama children tested positive for COVID-19 when they were taken to hospital. The agency also said none of the children had a previously documented case of SARS-CoV-2, also known as the PCC virus, nor had they received the COVID-19 vaccine.
Some research suggests that a previously unrecognized infection with the SARS-CoV-2 coronavirus may be behind the mysterious cases of severe hepatitis in children.
Children with COVID-19 have a significantly higher risk of having liver dysfunction later, according to a recent report published in medRxiv, which has not yet been peer-reviewed.
But most children with acute hepatitis, which is usually uncommon in this age group, do not report a previous SARS-CoV-2 infection. In contrast, most of them have been found to be infected with an adenovirus called 41F, which is not known to attack the liver.
People enter Georgia Children’s Hospital in Augusta, Ga., January 14, 2022. (Hannah Beier / Reuters)
A separate team of researchers suggests to The Lancet Gastroenterology & Hepatology that the affected children, many of whom are too young to be vaccinated, may have had mild or asymptomatic COVID-19 infections that went unnoticed.
One theory proposed by the researchers is that persistent coronavirus particles in the gastrointestinal tract in these children may be preparing the immune system to overreact to adenovirus-41F by producing large amounts of inflammatory proteins that then damage the liver.
“We suggest that children with acute hepatitis be investigated for the persistence of SARS-CoV-2 in feces” and other signs that liver damage is occurring because the coronavirus ear protein is a “superantigen” that oversensens the immune system. , said the researchers.
Other experts have suggested that as a result of social distancing and other COVID-19-related countermeasures, young children have been less likely to be exposed to adenovirus, which would have helped boost their immunity. In these cases, it is theorized, children’s immune systems may respond to an adenovirus infection by producing excess inflammatory proteins.
Further study is needed to confirm either theory, according to Dr. Rima Fawaz, a pediatric liver disease specialist at Yale School of Medicine.
Reuters contributed to this report.