High population burden of Omicron variant (B.1.1.529) is associated with the emergence of severe hepatitis of unknown etiology in children

Nishiura, Hiroshi; Jung, Sung-mok; Hayashi, Katsuma

doi:10.1016/j.ijid.2022.05.028

Cited by 26 publications

(18 citation statements)

References 7 publications

(8 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although correlation does not imply causation, the extensive infection in the child population during the Omicron wave in Europe and the US could reflect the current growth of acute severe hepatitis cases of unknown origin in children and predict the outbreak's evolution, supporting findings by Nishiura et al (2022) . Therefore, a transparent assessment and communication by governments and health authorities will be necessary as soon as possible to avoid speculation.…”

Section: To Editormentioning

confidence: 70%

“…We have read with great interest the short communication by Nishiura et al (2022) reporting that prior exposure to Omicron variant may be associated with an increased risk of severe hepatitis among children ( Nishiura et al 2022 ). Other authors also shown evidence from the previous SARS and the current SARS-CoV-2 that infected individuals can rapidly progress to a multiple organ dysfunction syndrome, among which the liver, even in asymptomatic cases ( Brisca et al, 2021 , Osborn et al, 2022 ).…”

Section: To Editormentioning

confidence: 99%

See 1 more Smart Citation

The COVID-19 pandemic management strategies and the acute severe hepatitis outbreak of unknown origin in children

Tobías

García-Alamino

Fonseca

et al. 2022

Clinical Infection in Practice

View full text Add to dashboard Cite

Section: To Editormentioning

confidence: 70%

Section: To Editormentioning

confidence: 99%

The COVID-19 pandemic management strategies and the acute severe hepatitis outbreak of unknown origin in children

Tobías

García-Alamino

Fonseca

et al. 2022

Clinical Infection in Practice

View full text Add to dashboard Cite

“…23 For those reasons, Brodin and Arditi suggest that children with acute hepatitis be investigated for SARS-CoV-2 persistence in stool, T-cell receptor skewing, and interferon gamma (IFN-γ) upregulation, because that would provide evidence of a SARS-CoV-2 superantigen mechanism in an adenovirus-41F-sensitized host. 18 Along the same lines, Nishiura et al 25 suggest that prior exposure to the Omicron variant (B.1.1.529) may be associated with an increased risk of severe hepatitis in children, indicating a critical need for cofactor studies. They analyzed the correlation between reported cases of Omicron variant and cases of acute hepatitis in children in 38 Organization for Economic Cooperation and Development countries and Romania between December 1, 2021, and April 27, 2022.…”

Section: Sars-cov-2 Acting As a Superantigenmentioning

confidence: 95%

Severe Acute Hepatitis of Unknown Origin in Children: What Do We Know Today?

Pérez‐Gracia¹,

Tarín-Pelló²,

Suay-García³

2022

J Clin Transl Hepatol

View full text Add to dashboard Cite

In May 2022, the UK International Health Regulations National Focal Point notified World Health Organization of 176 cases of severe acute hepatitis of unknown etiology in children under 10 years of age. From that moment on, cases of severe acute hepatitis of unknown origin in children began to be reported in several countries. As of June 17, 2022, a total of 991 cases had been reported in 35 countries worldwide, 50 children needed a liver transplant and 28 patients died. According to information published by ECDC, 449 cases have been detected in 21 EU countries. The children were between 1 month and 16 years of age. Adenovirus was detected in 62.2% of the analyzed samples. So far, the cause of these cases is unknown and many hypotheses remain open, but hepatitis A-E viruses and COVID-19 vaccines have been ruled out. A possible hypothesis has been published to explain the cause of these cases of severe hepatitis, according to which it could be a consequence of adenovirus infection in the intestine in healthy children previously infected with SARS-CoV-2. No other clear epidemiological risk factors have been identified to date. Thus, at this time, the etiology of the current cases of hepatitis remains under active investigation.

show abstract

“…This outbreak occurred during the COVID-19 pandemic, and more patients were found in countries with a high burden of Omicron variant infection [ 13 ]. UKHSA reported that more than 10% of patients had SARS-CoV-2 infection on admission or prior to admission [ 9 ].…”

Section: Hypothesized Etiologiesmentioning

confidence: 99%

Diagnosis, treatment, and prevention of severe acute hepatitis of unknown etiology in children

et al. 2022

View full text Add to dashboard Cite

Background Severe acute hepatitis of unknown etiology in children has recently exhibited a global trend of concentrated occurrence. This review aimed to summarize the current available information regarding the outbreak of severe acute hepatitis and introduce our hospital’s previous experiences with the diagnosis and treatment of severe acute hepatitis for reference. Data sources Websites including the UK Health Security Agency, European Centre for Disease Prevention and Control, CDC, WHO, and databases including PubMed/Medline, Cochrane Library, Embase and Web of Science were searched for articles on severe acute hepatitis in children. Results As of May 26, 2022, a total of 650 cases have been reported in 33 countries; at least 38 (6%) children required liver transplantation, and nine (1%) died. Cases are predominantly aged between 3 and 5 years old, and there are no epidemiological links among them. The common manifestations are jaundice, vomiting and pale stools. Adenovirus tested positive in most cases, and SARS-CoV-2 and other viruses were detected in a few cases, but virus particles were not found in liver tissue. Adenovirus immunohistochemistry showed immunoreactivity in the intrasinusoidal lumen from some liver samples. The hierarchical treatment includes symptomatic and supportive therapy, management of coagulation disorders and hepatic encephalopathy, artificial liver support, and liver transplantation (approximately 6%–10% of cases require liver transplant). Conclusions The etiology of this severe acute hepatitis in children is not clear. The clinical features are severe acute hepatitis with significantly elevated liver enzymes. Clinicians need to be alert to children with hepatitis.

show abstract

High population burden of Omicron variant (B.1.1.529) is associated with the emergence of severe hepatitis of unknown etiology in children

Cited by 26 publications

References 7 publications

The COVID-19 pandemic management strategies and the acute severe hepatitis outbreak of unknown origin in children

The COVID-19 pandemic management strategies and the acute severe hepatitis outbreak of unknown origin in children

Severe Acute Hepatitis of Unknown Origin in Children: What Do We Know Today?

Diagnosis, treatment, and prevention of severe acute hepatitis of unknown etiology in children

Contact Info

Product

Resources

About