Covid-19 could be linked to a spate of cases involving severe liver inflammation in children reported in more than a dozen countries worldwide, scientists have said.
At least 348 children have been diagnosed with unexplained hepatitis, forcing some to undergo liver transplants. A small number have died.
The cases are predominantly in children under 5, who showed initial symptoms of gastroenteritis, including diarrhoea and nausea, followed by the onset of jaundice.
Many of the children were found to be infected with an adenovirus infection, which is believed to play a role in the development of the condition.
Adenoviruses are a group of common viruses that infect the lining of the eyes, airways and lungs, intestines, urinary tract, and nervous system.
Yet experts said it does not fully explain their symptoms, because adenovirus does not typically cause hepatitis in healthy children.
However, a new theory shared in The Lancet, the British medical journal, said a coronavirus infection could be at the root of the cause.
According to the hypothesis, a Covid-19 infection could linger in the gastroenterological tract of the children affected, where it could come into contact with the adenovirus, causing the immune system to overreact.
“Sars-CoV-2 viral persistence in the gastrointestinal tract can lead to the repeated release of viral proteins across the intestinal epithelium, giving rise to immune activation,” wrote the authors of the correspondence, which appeared in the Lancet Gastroenterology & Hepatology.
Investigations recently turned towards previous exposure and infections with Covid.
"Over the past week, there's been some important progress with the further investigations and some refinements of the working hypotheses," said Philippa Easterbrook, from the WHO's global hepatitis programme, last week.
"At present, the leading hypotheses remain those which involve adenovirus ― with also still an important consideration about the role of Covid as well, either as a co-infection or a past infection," Ms Easterbrook said.
Experts said the cause is still speculative and research is continuing.
Dr Bharat Pankhania, a senior consultant in communicable disease control and senior lecturer at the University of Exeter in the UK, said “it could well be” that two factors are causing the hepatitis cases in children.
“A sensitised immune system with Covid, and that immune system acts exuberantly and causes hepatitis,” he said. “At this moment we don’t know for sure.
“Could it be triggered by an infectious agent? Your immune system is perked up, and another infection comes along, and the two infections together make the situation a lot worse.
“We’re exploring that second hypothesis. It could be a complex cascade of immune responses causing it.”
Prof Ian Jones, a professor of virology at the University of Reading in the UK, said the hypothesis involving Covid-19 “seems plausible”. However, he added it was unclear why the children have suffered hepatitis specifically, rather than wider symptoms caused by over-activation of the immune system.
“I would have thought if you had hyperactivity, you would’ve had a range of symptoms,” he said.
“Why are you seeing the focus on the liver, why aren’t there general inflammatory [symptoms affecting] other organs like the skin or kidney or even the lungs?”
Prof Eskild Petersen, of Aarhus University Hospital in Denmark and chairperson of the European Society of Clinical Microbiology and Infectious Diseases, said suggested links between the adenovirus and the hepatitis cases were “highly speculative” because the adenovirus had not been detected in the affected children’s liver tissue.
“I don’t think the evidence of the adenovirus connection is very strong," he said. "It’s the same with legacy Covid. Nobody has demonstrated these children have virus in their liver cells."
Prof Petersen, who is editor of the International Journal of Infectious Diseases, said the cases could, however, have some link to Covid-19, with the virus causing an elevated reaction by the immune system in certain people.
“I still think maybe because of a certain genetic background, Covid could prime them for autoimmune hepatitis, but at present, it’s all based on guesses,” he said.
A British scientist investigating a mysterious global hepatitis outbreak that has infected hundreds of children globally told The National recently she believes researchers are getting closer to identifying its cause.
Judith Breuer, professor of virology and director of the pathogen genomics unit at University College London, said Omicron's role is a "big question", but added "we don't have the answer".
Although many of the children have tested positive for Covid, metagenomic tests have seemed to play down an adverse reaction to Omicron as the main cause, she said.
"We haven't found Omicron in our tests as a whole, but it has certainly has been found in some children," Prof Breuer said. "We haven't found it from our metagenomics, for example. So at the moment, it remains uncertain what role it might have in the genesis of this problem".
Children receive Covid vaccinations - in pictures
How the bonus system works
The two riders are among several riders in the UAE to receive the top payment of £10,000 under the Thank You Fund of £16 million (Dh80m), which was announced in conjunction with Deliveroo's £8 billion (Dh40bn) stock market listing earlier this year.
The £10,000 (Dh50,000) payment is made to those riders who have completed the highest number of orders in each market.
There are also riders who will receive payments of £1,000 (Dh5,000) and £500 (Dh2,500).
All riders who have worked with Deliveroo for at least one year and completed 2,000 orders will receive £200 (Dh1,000), the company said when it announced the scheme.
Nancy 9 (Hassa Beek)
Nancy Ajram
(In2Musica)
SHOW COURTS ORDER OF PLAY
Wimbledon order of play on Saturday, July 8
All times UAE ( 4 GMT)
Centre Court (4pm)
Agnieszka Radwanska (9) v Timea Bacsinszky (19)
Ernests Gulbis v Novak Djokovic (2)
Mischa Zverev (27) v Roger Federer (3)
Court 1 (4pm)
Milos Raonic (6) v Albert Ramos-Vinolas (25)
Anett Kontaveit v Caroline Wozniacki (5)
Dominic Thiem (8) v Jared Donaldson
Court 2 (2.30pm)
Sorana Cirstea v Garbine Muguruza (14)
To finish: Sam Querrey (24) leads Jo-Wilfried Tsonga (12) 6-2, 3-6, 7-6, 1-6, 6-5
Angelique Kerber (1) v Shelby Rogers
Sebastian Ofner v Alexander Zverev (10)
Court 3 (2.30pm)
Grigor Dimitrov (13) v Dudi Sela
Alison Riske v Coco Vandeweghe (24)
David Ferrer v Tomas Berdych (11)
Court 12 (2.30pm)
Polona Hercog v Svetlana Kuznetsova (7)
Gael Monfils (15) v Adrian Mannarino
Court 18 (2.30pm)
Magdalena Rybarikova v Lesia Tsurenko
Petra Martic v Zarina Diyas
MOUNTAINHEAD REVIEW
Starring: Ramy Youssef, Steve Carell, Jason Schwartzman
Director: Jesse Armstrong
Rating: 3.5/5
Quick%20facts
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Six large-scale objects on show
- Concrete wall and windows from the now demolished Robin Hood Gardens housing estate in Poplar
- The 17th Century Agra Colonnade, from the bathhouse of the fort of Agra in India
- A stagecloth for The Ballet Russes that is 10m high – the largest Picasso in the world
- Frank Lloyd Wright’s 1930s Kaufmann Office
- A full-scale Frankfurt Kitchen designed by Margarete Schütte-Lihotzky, which transformed kitchen design in the 20th century
- Torrijos Palace dome
Company profile
Company: Verity
Date started: May 2021
Founders: Kamal Al-Samarrai, Dina Shoman and Omar Al Sharif
Based: Dubai
Sector: FinTech
Size: four team members
Stage: Intially bootstrapped but recently closed its first pre-seed round of $800,000
Investors: Wamda, VentureSouq, Beyond Capital and regional angel investors
England's lowest Test innings
- 45 v Australia in Sydney, January 28, 1887
- 46 v West Indies in Port of Spain, March 25, 1994
- 51 v West Indies in Kingston, February 4, 2009
- 52 v Australia at The Oval, August 14, 1948
- 53 v Australia at Lord's, July 16, 1888
- 58 v New Zealand in Auckland, March 22, 2018
RACECARD
4.30pm Jebel Jais – Maiden (PA) Dh60,000 (Turf) 1,000m
5pm: Jabel Faya – Maiden (PA) Dh60,000 (T) 1,000m
5.30pm: Al Wathba Stallions Cup – Handicap (PA) Dh70,000 (T) 2,200m
6pm: The President’s Cup Prep – Conditions (PA) Dh100,000 (T) 2,200m
6.30pm: Abu Dhabi Equestrian Club – Prestige (PA) Dh125,000 (T) 1,600m
7pm: Al Ruwais – Group 3 (PA) Dh300,000 (T) 1,200m
7.30pm: Jebel Hafeet – Maiden (TB) Dh80,000 (T) 1,400m
UAE currency: the story behind the money in your pockets
German plea
Ukrainian President Volodymyr Zelenskyy told the German parliament that. Russia had erected a new wall across Europe.
"It's not a Berlin Wall -- it is a Wall in central Europe between freedom and bondage and this Wall is growing bigger with every bomb" dropped on Ukraine, Zelenskyy told MPs.
Mr Zelenskyy was applauded by MPs in the Bundestag as he addressed Chancellor Olaf Scholz directly.
"Dear Mr Scholz, tear down this Wall," he said, evoking US President Ronald Reagan's 1987 appeal to Soviet leader Mikhail Gorbachev at Berlin's Brandenburg Gate.
MATCH INFO
Asian Champions League, last 16, first leg:
Al Jazira 3 Persepolis 2
Second leg:
Monday, Azizi Stadium, Tehran. Kick off 7pm
BIGGEST CYBER SECURITY INCIDENTS IN RECENT TIMES
SolarWinds supply chain attack: Came to light in December 2020 but had taken root for several months, compromising major tech companies, governments and its entities
Microsoft Exchange server exploitation: March 2021; attackers used a vulnerability to steal emails
Kaseya attack: July 2021; ransomware hit perpetrated REvil, resulting in severe downtime for more than 1,000 companies
Log4j breach: December 2021; attackers exploited the Java-written code to inflitrate businesses and governments
Chatham House Rule
A mark of Chatham House’s influence 100 years on since its founding, was Moscow’s formal declaration last month that it was an “undesirable
organisation”.
The depth of knowledge and academics that it drew on
following the Ukraine invasion had broadcast Mr Putin’s chicanery.
The institute is more used to accommodating world leaders,
with Nelson Mandela, Margaret Thatcher among those helping it provide
authoritative commentary on world events.
Chatham House was formally founded as the Royal Institute of
International Affairs following the peace conferences of World War One. Its
founder, Lionel Curtis, wanted a more scientific examination of international affairs
with a transparent exchange of information and ideas.
That arena of debate and analysis was enhanced by the “Chatham
House Rule” states that the contents of any meeting can be discussed outside Chatham
House but no mention can be made identifying individuals who commented.
This has enabled some candid exchanges on difficult subjects
allowing a greater degree of free speech from high-ranking figures.
These meetings are highly valued, so much so that
ambassadors reported them in secret diplomatic cables that – when they were
revealed in the Wikileaks reporting – were thus found to have broken the rule. However,
most speeches are held on the record.
Its research and debate has offered fresh ideas to
policymakers enabling them to more coherently address troubling issues from climate
change to health and food security.
