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Distinct Patterns of Liver Chemistry Changes in Pediatric Acute Hepatitis of Unknown Origin and COVID-19 Patients: A

Carly Van Wylick1, Lauren Lewis1, Daniel J Mulder1

  • 1Pediatrics, Queen's University, Kingston, CAN.

Cureus
|May 16, 2024
PubMed

Insights

Pediatric acute hepatitis of unknown origin (AHUO) shows distinct liver enzyme patterns compared to COVID-19. These differences suggest AHUO is not solely caused by SARS-CoV-2 infection.

Area of Science:

  • Hepatology
  • Virology
  • Pediatric Gastroenterology

Background:

  • Clusters of pediatric acute hepatitis of unknown origin (AHUO) emerged globally in 2021-2022.
  • AHUO coincided with a global resurgence of COVID-19, necessitating differentiation.

Purpose of the Study:

  • To compare liver biochemistry patterns between AHUO and COVID-19 patients.
  • To identify potential distinguishing features of AHUO.

Main Methods:

  • Systematic literature review to identify studies on AHUO and COVID-19 liver chemistries.
  • Extracted alanine aminotransferase (ALT), aspartate aminotransferase (AST), bilirubin, and international normalized ratio (INR).
  • Normalized liver chemistries by age-specific upper limit of normal.

Main Results:

  • Significantly higher ALT and AST elevations in AHUO compared to COVID-19.
  • INR elevations were also statistically higher in the AHUO group.
  • Liver chemistry changes showed distinctions, not strongly correlated with age.

Conclusions:

  • The distinct liver chemistry patterns suggest AHUO is not solely driven by SARS-CoV-2 infection.
  • Differentiating AHUO from COVID-19 based on liver function tests alone may be challenging.

Keywords:
disease outbreakemerging communicable diseasesliver disease etiologyliver failurepediatric hepatology

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