With a manageable Covid case, healthcare professionals are rassling with the unprecedented mystery of unexplained hepatitis in Covid positive children.  A team of medics from the Bundelkhand Medical College (BMC), Sagar, Madhya Pradesh, and the Post Graduate Institute of Medical Research, Chandigarh reported in the first systematic investigation that out of 475 children who tested positive for Covid from April to July 2021, about 8% (37 children) had Covid Acquired Hepatitis (CAH). Another 10 children were reported with a more serious but documented case of Multisystem Inflammatory Syndrome (MIS-C) in children. MIS-C is diagnosed as inflammation in multiple organs and has a mortality rate of three in every ten affected patients.

CAH manifests in nausea, appetite loss, weakness, mild fever, and an elevated liver enzyme level transaminase whereas all other associated factors such as viruses are absent. Sumit Rawat, Associate Professor, Microbiology, BMC, and the corresponding author stated that Hepatitis A and E are specific to a certain region with hepatitis B present across the nation and Hepatitis D spreads from the parent or a blood transfusion, however, after Covid infection with Delta variant, the usual history and pattern were changed. 

On a global scale, WHO has associated this spike in hepatitis cases with adenovirus along with a COVID 19 infection with the CDC imposing a nationwide alert about the increase in hepatitis cases of unknown origin. Mr. Rawat added that the adenovirus is harmless on its own, however, a compromised immune system can be easily infected. He also stated Covid jab can be useful as seen in the UK, vaccinated children have a reduced risk of infection.