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A Case of Severe Hepatitis in Infant Twins With COVID-19

Aaron L Heston1, Varun Sharma2, Taryn Johnson1

  • 1Pediatrics, Phoenix Children's Hospital, Phoenix, USA.

Cureus
|August 17, 2023
PubMed

Insights

Nine-month-old twins experienced jaundice and green diarrhea. COVID-19 infection was incidentally diagnosed, and symptoms resolved within two months, highlighting a potential link between SARS-CoV-2 and pediatric liver injury.

Area of Science:

  • Pediatric Gastroenterology
  • Hepatology
  • Infectious Diseases

Background:

  • Jaundice and gastrointestinal symptoms in infants can indicate various underlying conditions.
  • Differentiating causes of pediatric liver injury is crucial for timely and effective management.

Observation:

  • A case of nine-month-old twins presenting with acute jaundice and bright green diarrhea.
  • Initial laboratory findings revealed elevated liver enzymes and bilirubin without signs of liver failure.
  • Standard infectious and autoimmune workups for liver injury were negative in both infants.

Findings:

  • Both twins were incidentally diagnosed with coronavirus disease 2019 (COVID-19) via hospital protocol testing.
  • No respiratory symptoms were observed in either twin, suggesting a non-respiratory manifestation of COVID-19.
  • Clinical and laboratory parameters showed gradual improvement, with full resolution of symptoms and abnormalities within two months post-discharge.

Implications:

  • This case suggests a potential association between COVID-19 infection and pediatric cholestatic liver injury.
  • Highlights the importance of considering COVID-19 in the differential diagnosis of unexplained liver abnormalities in children, even without respiratory symptoms.
  • Further research is warranted to elucidate the mechanisms and clinical spectrum of SARS-CoV-2-related liver injury in pediatric populations.

Keywords:
covid 19hepatology & gasrtroenterologyliver fibrosispediatric case with covid-19pediatric gastroenterology

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