WHO studies link between COVID-19 and mysterious hepatitis in children

On May 10, the World Health Organization (WHO) reported that 348 likely cases of hepatitis of unknown etiology were identified. The leading hypotheses are still those related to adenovirus.

Hepatitis cases have been reported in 20 countries, with 70 additional cases from 13 other countries pending confirmation.

More than 160 cases have been reported in the UK and only 6 countries have reported more than 5 cases.

AFP quoted Ms. Philippa Easterbrook, an expert with WHO’s global hepatitis program, as saying that there had been some important progress with further investigations. She said Britain has coordinated a comprehensive series of studies looking at the genetics of affected children, the child’s immune response, the virus and further epidemiological studies.

WHO was first notified on April 4 of 10 cases of hepatitis of unknown cause in Scotland, detected in children under 10 years of age.

The US Centers for Disease Control and Prevention is investigating 109 such cases, including five reported deaths.

“Currently, the leading hypotheses are still those related to adenovirus – there are also important considerations about the role of COVID-19as a co-infection or a disease that has been acquired in the past,” Ms. Easterbrook said.

Further tests over the past week have confirmed that about 70% of cases are positive for adenovirus, with subtype 41 – often associated with gastroenteritis – the common subtype.

Testing also showed that about 18 percent of cases tested positive for COVID-19.

The big focus next week will be looking at serological testing for previous COVID-19 exposures and infections, Ms. Easterbrook said.

The scientist said that data from the UK on case-control studies are needed to compare whether adenovirus detection rates differ from those in other hospitalized children. Microscopic studies of liver samples and biopsies have not revealed any typical features that can occur with adenoviral hepatitis, she said.

Adenovirus is usually spread by close contact with individuals, respiratory droplets, and surfaces. They are commonly known to cause respiratory symptoms, conjunctivitis or even digestive upset.

WHO refers to outbreaks of severe hepatitis episodes as acute hepatitis of unknown etiology in young children. Three children in Indonesia have died from the disease. Some cases have caused liver failure and require a transplant. Many cases became jaundiced and experienced gastrointestinal symptoms including abdominal pain, diarrhea, and vomiting.

After discovering the first 169 cases, WHO says common viruses that cause Hepatitis Acute viruses (hepatitis A, B, C, D and E viruses) were not detected in any of the cases.