What do doctors say about acute hepatitis with SARS-CoV-2 virus?

According to information from the World Health Organization (WHO), the world has so far recorded about 350 cases of the disease acute hepatitis of unknown etiology in children in 25 countries. In Vietnam, there are currently no recorded cases of this type of hepatitis infection.

Dr. Nguyen Pham Anh Hoa, Head of the Department of Hepatology (National Hospital of Pediatrics), said that acute hepatitis is a condition in which the liver is newly damaged due to many causes such as viruses, bacteria, toxins, other conditions. metabolic disorders, hemodynamic disorders, immune disorders or systemic diseases…

This leads to the destruction of liver cells. Most cases of acute hepatitis are reversible once the causative agent is eliminated.

Children with abnormal signs of health need to be taken to a medical facility for examination – Illustration

In a few cases, the course of the disease is severe, causing irreversible liver failure and possibly death. In some cases, the disease can progress for a long time, leading to chronic liver disease, cirrhosis, etc.

The WHO said the first cases were reported in Europe and North America, and a rapidly increasing number of cases were recorded in many countries around the world. Several countries in Asia and Southeast Asia have also reported cases.

From the first cases recorded in October 2021, as of May 10, there have been 348 cases in 25 countries, an increase of 70 cases compared to the organization’s report on June 6. 5.

According to WHO, acute hepatitis of unknown etiology in children has some common features as follows:

The cases are children aged 0-16 years old. Young children get sick more often. There are one or more symptoms such as fever, abdominal pain, vomiting, diarrhea, etc. There are symptoms of liver damage of varying degrees, such as jaundice, yellowing of the eyes, discolored stools, destruction of liver cells. increased levels of liver enzymes in the blood).

No known common causes of liver damage have been found. Patients can recover after active supportive treatment, however, in some severe cases, irreversible liver failure is required, liver transplantation is required and there have been cases of death.

“Parents need to pay attention to monitor their children, if children have suspicious signs such as jaundice, yellow eyes, pale stools, lethargy, etc., they need to take the child to a medical facility to be diagnosed. Early and timely treatment” – Dr. Hoa emphasized.

Disease of unknown cause

According to Dr. Nguyen Pham Anh Hoa, through reports around the world, the exact cause of these acute hepatitis cases has not been identified yet.

Up to now, in the world, the rate of liver damage causing acute liver failure of unknown cause still fluctuates in the range of 25-30%. However, these cases are quite sporadic and do not appear in clusters like the hepatitis cases of unknown cause that are being mentioned a lot in recent days.

There are a number of hypotheses being put forward and scientists are focusing on research and clarification such as: The relationship of Adeno virus, especially Adeno virus strain 41, to the onset of acute liver injury; the role of causing liver damage of the SARS-CoV-2 virus (which causes Covid-19 disease)

Or the emergence of a new virus variant or not? Changes and immune response of children after Covid-19 infection, as well as response to other common viruses….

According to WHO, 70% of patients in the hepatitis group of unknown cause in the UK and 50% of cases in the US have been found to have adenovirus 41 strain.

Regarding the Adeno virus, Dr. Hoa said this is a virus that has been discovered since 1953 with many strains and can cause disease in many organs. The most common lesions caused by the Adeno virus are respiratory infections, conjunctivitis (pink eye), cystitis, meningitis, etc.

After Rota virus, Adeno virus is the second cause of diseases in the gastrointestinal tract with symptoms in the stomach and intestines… In young children, common digestive disorders caused by Adeno virus include diarrhea, vomiting, sadness. vomit.

According to previous studies, evidence from antibody testing shows that most children have had at least one adenovirus infection between 0 and 4 years of age. In the past, there have been isolated reports of several pediatric patients with this virus causing liver damage in immunocompromised children.

“However, up to now, there is not enough evidence to confirm that Adeno virus is the cause of disease in the above group of children with acute hepatitis, however, the recognition of the presence of Adeno virus in some pediatric patients needs to be continued. continue to monitor and research in the near future,” said Dr. Hoa.

No relationship between Covid-19 vaccine and acute hepatitis was found

Is the SARS-CoV-2 virus the cause of the disease?

To date, out of nearly 350 cases, some children have tested positive for the SARS-CoV-2 virus. 10-18% of sick children have evidence of co-infection with SARS-CoV-2 virus and adenovirus. The role of the SARS-CoV-2 virus in causing disease is not really clear and needs to be further studied.

According to statistics, the majority of sick children are young children who have not been vaccinated against Covid-19. Therefore, there is no association between the Covid-19 vaccine and acute hepatitis.

How is the disease treated?

According to experts, because the cause of the disease has not been determined, there is no specific treatment. The main treatment measures are symptomatic treatment and supportive treatment, including aggressive resuscitation measures for severe liver failure cases such as plasma exchange, continuous dialysis… and possibly liver transplantation. emergency.

The goal is to provide early supportive treatment for children to limit the level of damage to the lowest level and enhance the ability to restore liver function and liver transplantation in case of decompensated liver failure.

Notes to prevent acute hepatitis in children

Hoa said that until now, the cause of liver damage in this group of patients is still unknown, so it is not possible to recommend proactive and specific preventive measures. However, young parents should not be too alarmed. It is necessary to be calm and attentive to detect early symptoms of gastrointestinal disease and liver damage in children.

“Children who have symptoms of fever, abdominal pain, vomiting – nausea, diarrhea, fatigue, jaundice, conjunctivitis … should be examined at medical facilities” – Doctor Hoa recommended.

While waiting for research results to confirm the cause of the disease in order to have specific measures, disease prevention should adhere to the following principles:

– Practice good personal hygiene, wear masks, wash hands often, especially before preparing food, before eating, after cleaning.

– Fully immunize children according to the immunization schedule, including hepatitis B, hepatitis A and Covid-19 vaccines when indicated.

– Use clean food sources, ensure food hygiene and safety

– Pay special attention to the prevention of diseases for children in schools and kindergartens by ensuring hygiene, using separate personal items (drinking cups, spoons, eating bowls, face towels…); good cleaning and disinfection of surfaces; proper waste disposal.

According to N.Dung