Key TakeawaysPediatric cases of hepatitis of unknown origin have been identified worldwide, including in the United States.Researchers have wondered if COVID-19 might be related to the cases, but more research is needed.Even if the virus isn’t the cause of the mysterious hepatitis cases in kids, COVID can still lead to serious illness and even death. Vaccinating children against COVID is the best way to protect them.
Key Takeaways
Pediatric cases of hepatitis of unknown origin have been identified worldwide, including in the United States.Researchers have wondered if COVID-19 might be related to the cases, but more research is needed.Even if the virus isn’t the cause of the mysterious hepatitis cases in kids, COVID can still lead to serious illness and even death. Vaccinating children against COVID is the best way to protect them.
In April 2022, cases ofhepatitisof unknown cause in children were first identified in the United Kingdom and Northern Ireland.About a week later, the World Health Organization (WHO) revealed that at least 169 pediatric cases of acute hepatitis of unknown origin had been reported from more than 12 countries.
The unexpected and significant increase in cases of hepatitis in previously healthy children prompted health authorities worldwide to investigate the cases and try to determine the cause.
In the United States, the Centers for Disease Control and Prevention (CDC) stated that it was investigating about 180 reports of pediatric patients with hepatitis of unknown cause as of May 18.The CDC is working with health departments across the country to look for possible causes and identify more hepatitis cases.
While there is no definitive evidence of a link, one possibility being explored is whether the hepatitis cases in kids could be related toCOVID-19.
Mysterious Hepatitis Cases Identified in U.S. Kids
What Do We Know So Far?
Between October 2021 and February 2022, the CDC identified nine children who had been hospitalized with acute hepatitis in the U.S.
The patients’ test results ruled out many possible causes of pediatric hepatitis, including:
The 5 Types of Viral Hepatitis
Could Adenovirus and COVID-19 Be to Blame?
Early investigations didn’t link the hepatitis cases to COVID-19 at all. But a newer, small study suggests the link is possible.
While adenovirus has been a strong lead for researchers to explore, the cause of the hepatitis cases is still currently unknown.
“The WHO and the CDC are working with public health officials to monitor and understand an increase in hepatitis of unknown cause recently reported in children,”Michael Wilsey, MD, a pediatric gastroenterologist and vice-chair of the Division of Gastroenterology at Johns Hopkins All Children’s Hospital, told Verywell.
In early June, a study published in theJournal of Pediatric Gastroenterology and Nutritionreported five cases of pediatric patients who recovered from COVID-19 but later developed liver injury—either acute liver failure or hepatitis with cholestasis.
In this group of patients, adenovirus was not found in the children’s livers—which suggests the virus was not the cause of the illness. The researchers thought that the liver problems could have been a post-infectious immune reaction similar toMIS-Cor immune dysregulation from prior infection with SARS-CoV-2.
However, Wilsey said that “it may be too soon to tell whether a previous infection with the COVID-19 virus is related to the recent rise in hepatitis cases in children with unknown etiology.”
Can COVID Cause Hepatitis?
Although the five pediatric cases present a new hypothesis for the unexplained cases of hepatitis, it does not establish a causal connection. Wilsey said that while viral infections can prime the immune system to have an inflammatory response, an association does not necessarily mean causation.
Michael Wilsey, MDIt is too soon to tell if there is a definitive link between past COVID-19 infection and liver disease in children.
Michael Wilsey, MD
It is too soon to tell if there is a definitive link between past COVID-19 infection and liver disease in children.
Alexander Weymann, MD, a pediatric gastroenterologist, hepatologist, and the director of the Liver Center at Nationwide Children’s Hospital, told Verywell that it’shypotheticallypossible for COVID to cause hepatitis.
More research is needed on pediatric cases of hepatitis of unknown cause, including whether they could be related to COVID infection or evenlong COVID.
What to Know About COVID-19 and Liver Disease
Can You Prevent Hepatitis?
Viruses, medications, and health conditions can all cause hepatitis. You can’t always avoid these factors, which means you may not be able to prevent hepatitis.
According to Weymann, the following strategies can help prevent some types of hepatitis:
Is There a Vaccine for Hepatitis?
Know the Signs of Hepatitis
Caregivers of young children should know the signs and symptoms of hepatitis. Weymann said that the most important sign a person could have hepatitis (or liver disease in general) isyellowing of the skin and the white part of the eyes(jaundice).
Other symptoms of hepatitis include:
However, hepatitis symptoms can be vague. Weymann said that while fatigue, loss of appetite, nausea, and vomiting can be symptoms of hepatitis, they can also be symptoms of other more common illnesses.
What Are the Symptoms of Hepatitis?
What Caregivers Can Do
“If parents detect or suspect symptoms of hepatitis in their child, they should contact their pediatrician or primary care provider immediately,” said Weymann. “Hepatitis, while often mild and self-limited, can be or become a serious and even life-threatening illness.”
As for COVID? Even if the virus is not causing hepatitis in kids, it can still lead to severe illness andeven death. Right now, the best way to protect children against the risks of COVID isvaccination.
“It is too soon to tell if there is a definitive link between past COVID-19 infection and liver disease in children,” said Wilsey. “Current CDC guidelines and routine supportive care should be followed for children with diagnosed or suspected SARS-CoV-2 viral infection.”
What This Means For YouResearchers are still trying to figure out what is causing cases of acute hepatitis in kids around the world. Even if COVID-19 is not a cause of hepatitis cases in children, the virus can still cause severe illness and even death. Children should get vaccinated against COVID as soon as possible.
What This Means For You
Researchers are still trying to figure out what is causing cases of acute hepatitis in kids around the world. Even if COVID-19 is not a cause of hepatitis cases in children, the virus can still cause severe illness and even death. Children should get vaccinated against COVID as soon as possible.
6 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.World Health Organization.Acute hepatitis of unknown aetiology – the United Kingdom of Great Britain and Northern Ireland.World Health Organization.Multi-country – acute, severe hepatitis of unknown origin in children.Centers for Disease Control and Prevention.Update on children with acute hepatitis of unknown cause.Baker JM, Buchfellner M, Britt W, et al.Acute hepatitis and adenovirus infection among children — Alabama, October 2021–February 2022.MMWR Morb Mortal Wkly Rep. 2022;71(18):638–640. doi:10.15585/mmwr.mm7118e1Centers for Disease Control and Prevention.Children with hepatitis of unknown cause.Cooper S, Tobar A, Konen O, et al.Long COVID-19 liver manifestation in children.J Pediatr Gastroenterol Nutr. Published online June 10, 2022. doi:10.1097/MPG.0000000000003521
6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.World Health Organization.Acute hepatitis of unknown aetiology – the United Kingdom of Great Britain and Northern Ireland.World Health Organization.Multi-country – acute, severe hepatitis of unknown origin in children.Centers for Disease Control and Prevention.Update on children with acute hepatitis of unknown cause.Baker JM, Buchfellner M, Britt W, et al.Acute hepatitis and adenovirus infection among children — Alabama, October 2021–February 2022.MMWR Morb Mortal Wkly Rep. 2022;71(18):638–640. doi:10.15585/mmwr.mm7118e1Centers for Disease Control and Prevention.Children with hepatitis of unknown cause.Cooper S, Tobar A, Konen O, et al.Long COVID-19 liver manifestation in children.J Pediatr Gastroenterol Nutr. Published online June 10, 2022. doi:10.1097/MPG.0000000000003521
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
World Health Organization.Acute hepatitis of unknown aetiology – the United Kingdom of Great Britain and Northern Ireland.World Health Organization.Multi-country – acute, severe hepatitis of unknown origin in children.Centers for Disease Control and Prevention.Update on children with acute hepatitis of unknown cause.Baker JM, Buchfellner M, Britt W, et al.Acute hepatitis and adenovirus infection among children — Alabama, October 2021–February 2022.MMWR Morb Mortal Wkly Rep. 2022;71(18):638–640. doi:10.15585/mmwr.mm7118e1Centers for Disease Control and Prevention.Children with hepatitis of unknown cause.Cooper S, Tobar A, Konen O, et al.Long COVID-19 liver manifestation in children.J Pediatr Gastroenterol Nutr. Published online June 10, 2022. doi:10.1097/MPG.0000000000003521
World Health Organization.Acute hepatitis of unknown aetiology – the United Kingdom of Great Britain and Northern Ireland.
World Health Organization.Multi-country – acute, severe hepatitis of unknown origin in children.
Centers for Disease Control and Prevention.Update on children with acute hepatitis of unknown cause.
Baker JM, Buchfellner M, Britt W, et al.Acute hepatitis and adenovirus infection among children — Alabama, October 2021–February 2022.MMWR Morb Mortal Wkly Rep. 2022;71(18):638–640. doi:10.15585/mmwr.mm7118e1
Centers for Disease Control and Prevention.Children with hepatitis of unknown cause.
Cooper S, Tobar A, Konen O, et al.Long COVID-19 liver manifestation in children.J Pediatr Gastroenterol Nutr. Published online June 10, 2022. doi:10.1097/MPG.0000000000003521
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