Link between Covid and severe hepatitis in children discovered: the Israeli study

An Israeli research team has described the clinical cases of some children suffering from severe forms of hepatitis with a previous diagnosis of COVID-19.

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In recent weeks, hundreds of cases of a mysterious acute hepatitis have been diagnosed in children. Generally in the small this inflammation of the liver is (rarely) triggered by an adenovirus, but in many of these abnormal cases the pathogen has not been identified, effectively leavingunknown etiology. From the beginning, many experts thought of a possible connection with COVID-19the infection triggered by coronavirus SARS-CoV-2; now a new Israeli study seems to confirm this connection, at least in part diagnosis. More specifically, the association was found with Lang Covidset off persistent symptoms which may occur (or persist) even months after the negativeization, regardless of the severity of the disease.

To demonstrate the link between long covid and acute hepatitis in children, a research team was led by researchers from the Department of Gastroenterology, Nutrition and Liver Disease and Tel Aviv University, who collaborated closely with colleagues. Department of Pathology, Rabin Medical Center – Petach Tikva Beilinson Hospital, Department of Imaging, Metabolic Disease Clinic – Schneider Children’s Medical Center and the Genetics Unit. The researchers, coordinated by Dr. Shiri Cooper, a professor at the Sackler Faculty of Medicine at the Israeli University, came to their conclusions after analyzing the cases of some children hospitalized with severe liver damagewhich occurred after COVID-19.

As explained on Twitter by epidemiologist and biostatistician Zoe Hyde, four of these children had been affected by a mild form of COVID-19 before the onset of liver disease, while one tested positive for serological test; in simple terms had it antibodies against SARS-CoV-2 and had been hit by one asymptomatic form of the infection. On average, hepatitis occurred in children 74 days after the diagnosis COVID-19, Israeli researchers therefore believe that it may be a manifestation of Long Covid. More specifically, a 3-month-old infant had COVID-19 in February 2021 and was hospitalized for liver failure 21 days later; an 8-year-old boy had the infection in December 2020 and was admitted for hepatitis 130 days later; another 8-year-old boy tested positive in January 2021 and ended up in the hospital for hepatitis 94 days later; finally, a 13-year-old boy became infected in September 2021 and was admitted for hepatitis 53 days after diagnosis. A 5-month-old newborn was admitted for liver failure in May 2021 when he tested positive for antibodies to coronavirus. Doctors searched for adenovirus in the children’s livers, but found no trace of it; it was instead detected in the blood of three children, but since the liver manifestation was different from that normally caused by the pathogen, experts believe it was not responsible for the hepatitis.

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The children with acute hepatitis ended up in the hospital with two different clinical manifestations. The two 3 and 5 month old babies, “previously healthy”, as stated in the study summary, had oneacute liver failure which has been developed to the point that it is required liver transplantation. Their body presented “massive necrosis with cholangiolar proliferation (damage to the bile ducts NDR) and lymphocyte infiltrate”. The three children between the ages of 8 and 13 had hepatitis with them cholestasis (reduction or blockage of bile flow). The children were treated with steroids which resulted in improvement of liver enzymes and the clinical picture.

According to Dr. Cooper and colleagues, the hepatic manifestation in children is either “a post-infectious immune response similar to MIS-C”, triggered by the infection with SARS-CoV-2 coronavirus, or “a immune dysregulation which causes the release of other infectious agents such as adenovirus from a previous SARS-CoV-2 infection “. In short, coronavirus can trigger hepatitis directly or in synergy with another adenoviral pathogen. Vaccine against covid, as the affected children had not been vaccinated (vaccinations in Israel started at the end of November 2021 in the age group 5 – 11). The details of the research “Long COVID-19 Liver Manifestation in Children” have been published in the authoritative scientific journal Journal of Pediatric Gastroenterology and Nutrition.

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