Hepatitis in children: The course of COVID is getting stronger

What if Covid had something to do with it? A wave of acute hepatitis cases in children worries health authorities. Within a few weeks, at least 450 cases were documented worldwide, of which 31 required a liver transplant and 11 died. The cause of hepatitis, which mainly affects children under five, remains unknown. The most likely suspect at the moment is adenovirus AD-41, known to cause gastroenteritis-like illnesses in children, as it can be detected in the blood of most children with this hepatitis. But this course is not yet stable: first of all, because this adenovirus usually does not affect the liver; Also, because it was not found in liver biopsies taken from these patients, indicating that this organ was not directly infected with this virus. Another hypothesis under study is that the SARS-CoV-2 coronavirus is responsible for Covid-19. The hypothesis is supported by recent studies that the coronavirus will play an important role in triggering hepatitis.

COVID-19 in children can affect liver function

Several studies have already shown that Covid-19 can cause an increase in the concentration of several liver enzymes in the blood, in particular alanine aminotransferase (ALT) and aspartate aminotransferase (AST), as observed during hepatitis. This observation has just been confirmed in children by researchers at Case Western Reserve University (Cleveland, USA) in a preliminary version published online on May 14, 2022 (not yet peer-reviewed).

They compared a group of 245,000 children with Covid with a group of 550,000 children with other respiratory infections. After controlling for several risk factors, such as age, weight and ethnicity, they found that the risk of liver damage was higher in Covid patients, with abnormally high levels of these enzymes (ALT and AST) as well as bilirubin, a pigment that accumulates during hepatitis and causes jaundice. (or jaundice). This increased risk was present for up to six months after infection, which the authors say, “Suggests acute and prolonged hepatic sequelae in pediatric Covid-19 patients..

This hepatotoxic effect can be dangerous

However, this liver damage in Covid patients usually has no consequences, except for patients who already have liver disease. But a study published in May in Journal of pediatric gastroenterology and nutrition showed that these disorders can be dangerous even in patients who do not have a specific history of liver disease. Doctors at Children’s Hospital in Cincinnati (USA) have listed the case of a 3-year-old patient who developed autoimmune hepatitis after contracting a mild form of Covid.

This baby, who was otherwise healthy before the infection, was admitted to hospital three weeks after Covid with fatigue and jaundice.

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