Liver abnormalities following SARS-CoV-2 infection in children 1 to 10 years of age
Objective Beginning in October 2021 in the USA and elsewhere, cases of severe paediatric hepatitis of unknown aetiology were identified in young children. While the adenovirus and adenovirus-associated virus have emerged as leading aetiological suspects, we attempted to investigate a potential role...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2024-02-01
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| Series: | Family Medicine and Community Health |
| Online Access: | https://fmch.bmj.com/content/12/1/e002655.full |
| _version_ | 1797222525143351296 |
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| author | Rong Xu David C Kaelber Pamela B Davis Pauline Terebuh Veronica R Olaker Ellen K Kendall |
| author_facet | Rong Xu David C Kaelber Pamela B Davis Pauline Terebuh Veronica R Olaker Ellen K Kendall |
| author_sort | Rong Xu |
| collection | DOAJ |
| description | Objective Beginning in October 2021 in the USA and elsewhere, cases of severe paediatric hepatitis of unknown aetiology were identified in young children. While the adenovirus and adenovirus-associated virus have emerged as leading aetiological suspects, we attempted to investigate a potential role for SARS-CoV-2 in the development of subsequent liver abnormalities.Design We conducted a study using retrospective cohorts of deidentified, aggregated data from the electronic health records of over 100 million patients contributed by US healthcare organisations.Results Compared with propensity score matched children with other respiratory infections, children aged 1–10 years with COVID-19 had a higher risk of elevated transaminases (HR (95% CI) 2.16 (1.74 to 2.69)) or total bilirubin (HR (95% CI) 3.02 (1.91 to 4.78)), or new diagnoses of liver diseases (HR (95% CI) 1.67 (1.21 to 2.30)) from 1 to 6 months after infection. Patients with pre-existing liver abnormalities, liver abnormalities surrounding acute infection, younger age (1–4 years) or illness requiring hospitalisation all had similarly elevated risk. Children who developed liver abnormalities following COVID-19 had more pre-existing conditions than those who developed abnormalities following other infections.Conclusion These results indicate that SARS-CoV-2 may prime the patient for subsequent development of liver infections or non-infectious liver diseases. While rare (~1 in 1000), SARS-CoV-2 is a risk for subsequent abnormalities in liver function or the diagnosis of diseases of the liver. |
| first_indexed | 2024-03-08T11:31:11Z |
| format | Article |
| id | doaj.art-943ce06a73fb4e09a2f8fb3580aa552b |
| institution | Directory Open Access Journal |
| issn | 2305-6983 2009-8774 |
| language | English |
| last_indexed | 2024-04-24T13:22:43Z |
| publishDate | 2024-02-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Family Medicine and Community Health |
| spelling | doaj.art-943ce06a73fb4e09a2f8fb3580aa552b2024-04-04T11:40:09ZengBMJ Publishing GroupFamily Medicine and Community Health2305-69832009-87742024-02-0112110.1136/fmch-2023-002655Liver abnormalities following SARS-CoV-2 infection in children 1 to 10 years of ageRong Xu0David C Kaelber1Pamela B Davis2Pauline Terebuh3Veronica R Olaker4Ellen K Kendall5Center for Artificial Intelligence in Drug Discovery, Case Western Reserve University, Cleveland, OH, USAThe Center for Clinical Informatics Research and Education, The MetroHealth System, Cleveland, OH, USACenter for Community Health Integration, Case Western Reserve University, Cleveland, OH, USACenter for Artificial Intelligence in Drug Discovery, Case Western Reserve University, Cleveland, OH, USACenter for Artificial Intelligence in Drug Discovery, Case Western Reserve University, Cleveland, OH, USACenter for Artificial Intelligence in Drug Discovery, Case Western Reserve University, Cleveland, OH, USAObjective Beginning in October 2021 in the USA and elsewhere, cases of severe paediatric hepatitis of unknown aetiology were identified in young children. While the adenovirus and adenovirus-associated virus have emerged as leading aetiological suspects, we attempted to investigate a potential role for SARS-CoV-2 in the development of subsequent liver abnormalities.Design We conducted a study using retrospective cohorts of deidentified, aggregated data from the electronic health records of over 100 million patients contributed by US healthcare organisations.Results Compared with propensity score matched children with other respiratory infections, children aged 1–10 years with COVID-19 had a higher risk of elevated transaminases (HR (95% CI) 2.16 (1.74 to 2.69)) or total bilirubin (HR (95% CI) 3.02 (1.91 to 4.78)), or new diagnoses of liver diseases (HR (95% CI) 1.67 (1.21 to 2.30)) from 1 to 6 months after infection. Patients with pre-existing liver abnormalities, liver abnormalities surrounding acute infection, younger age (1–4 years) or illness requiring hospitalisation all had similarly elevated risk. Children who developed liver abnormalities following COVID-19 had more pre-existing conditions than those who developed abnormalities following other infections.Conclusion These results indicate that SARS-CoV-2 may prime the patient for subsequent development of liver infections or non-infectious liver diseases. While rare (~1 in 1000), SARS-CoV-2 is a risk for subsequent abnormalities in liver function or the diagnosis of diseases of the liver.https://fmch.bmj.com/content/12/1/e002655.full |
| spellingShingle | Rong Xu David C Kaelber Pamela B Davis Pauline Terebuh Veronica R Olaker Ellen K Kendall Liver abnormalities following SARS-CoV-2 infection in children 1 to 10 years of age Family Medicine and Community Health |
| title | Liver abnormalities following SARS-CoV-2 infection in children 1 to 10 years of age |
| title_full | Liver abnormalities following SARS-CoV-2 infection in children 1 to 10 years of age |
| title_fullStr | Liver abnormalities following SARS-CoV-2 infection in children 1 to 10 years of age |
| title_full_unstemmed | Liver abnormalities following SARS-CoV-2 infection in children 1 to 10 years of age |
| title_short | Liver abnormalities following SARS-CoV-2 infection in children 1 to 10 years of age |
| title_sort | liver abnormalities following sars cov 2 infection in children 1 to 10 years of age |
| url | https://fmch.bmj.com/content/12/1/e002655.full |
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