Concern over global outbreak of acute severe hepatitis of unknown etiology in children

ABSTRACT

Acute severe hepatitis in children of unknown cause is a childhood liver disease of unknown etiology that emerged suddenly during the global pandemic of coronavirus disease 2019. Since it was reported in early April 2022, it has involved more than 20 countries around the world with about 450 cases, mainly in Europe and North America, and no similar case has been reported in China. The disease occurs mostly in children under 5 years of age and is characterized mainly by liver disease manifestations such as jaundice and elevated transaminases, with rare respiratory symptoms;a few cases develop into liver failure and need liver transplantation, and most cases have a good prognosis. The disease is currently considered to be caused by infection, but the exact pathogen remains unclear. Adenovirus is detected in blood in many cases, so the possibility of infection caused by adenovirus should be considered;and factors such as lack of trained immunity and persistent inflammatory in children with COVID-19 should also be considered. The disease is no evidence of interpersonal transmission, infectivity is low, but the possibility of a pandemic outbreak in countries with a high prevalence of COVID-2019 needs to be guarded against;hand hygiene and respiratory protection may reduce the risk of morbidity. This article provides an overview of the epidemiological and clinical features of the disease and analyzes its nature, etiology and transmission risk in order to provide updated awareness of its clinical diagnosis and treatment.