A scientific study links severe acute hepatitis in children with Covid 19

Scientists around the world continue to investigate cases of severe hepatitis of unknown origin that continue to rise in several countries. There are already 450 patients affected globally, according to a report released by the European Center for Disease Prevention and Control (ECDC), almost 100 more than the 348 reported by the World Health Organization (WHO) in its last this week’s report.

In this context, specialists Petter Brodin and Moshe Arditi published a scientific study on Friday in the prestigious medical journal The Lancet, in which they investigated the causes of several of the detected cases of the disease of unknown origin.

See also: San Juan: a two-year-old boy was hospitalized for hepatitis of unknown origin

“Recently, there have been reports of children with a severe acute form of hepatitis in the UK, Europe, the US, Israel and Japan. Most patients present with gastrointestinal symptoms and then progress to jaundice and, in some cases, acute liver failure. So far, no common environmental exposures have been found and an infectious agent remains the most plausible cause.

According to the recent study, hepatitis of unknown origin would be linked to Covid 19. Illustrative photo courtesy
According to the recent study, hepatitis of unknown origin would be linked to Covid 19. Illustrative photo courtesy

“Hepatitis A, B, C, D and E viruses have not been found in these patients, but 72% of children with severe acute hepatitis in the UK who were tested had an adenovirus detected. , and of 18 subtyped cases in the UK, all were identified as adenovirus 41F. This is not an uncommon subtype but predominantly affects young children and immunocompromised patients. However, to our knowledge, adenovirus 41F has not previously been reported to cause severe acute hepatitis.

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Meanwhile, they stated that SARS-CoV-2 was identified in 18% of reported cases in the UK and in 11 (11%) of the 97 cases in England with available data that tested positive for SARS-CoV-2. 2 at admission; three other cases had tested positive in the 8 weeks prior to admission.

“Ongoing serological testing is likely to show an increased number of children with severe acute hepatitis and previous or current SARS-CoV-2 infection. 11 of 12 Israeli patients were reported to have had COVID 19 in recent months, and the majority of reported hepatitis cases were in patients too young to be eligible for COVID19 vaccines,” the scientists noted in the publication.

Illustrative image: Infobae
Illustrative image: Infobae

Furthermore, they explained that “SARS-CoV-2 infection can lead to the formation of a viral reservoir. The viral persistence of SARS-CoV-2 in the gastrointestinal tract can lead to the repeated release of viral proteins through the intestinal epithelium, resulting in immune activation.Such repeated immune activation could be mediated by a superantigen motif within the SARS-CoV-2 spike protein that resembles staphylococcal enterotoxin B, triggering a broad and nonspecific activation of T cells. This superantigen-mediated activation of immune cells has been proposed as a causal mechanism of multisystem inflammatory syndrome in children,” they maintained.

Paradoxically, the study authors clarified that acute hepatitis has been reported in children with multisystem inflammatory syndrome, but co-infection with other viruses was not investigated. And they came to the following conclusion: “We hypothesized that recently reported cases of severe acute hepatitis in children could be a consequence of adenovirus infection with intestinal trophism in children previously infected with SARS-CoV-2 and carriers of viral reservoirs” .

“Translated to the current situation, we suggest investigating SARS-CoV-2 persistence in faeces, T-cell receptor diversion, and IFN-γ upregulation in children with acute hepatitis, because this could provide evidence. of a SARS-CoV-2 superantigen,” the researchers noted, adding that “if evidence of superantigen-mediated immune activation is found, immunomodulatory therapies should be considered in children with severe acute hepatitis,” the scientists concluded.

Source: Infobae

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