SARS-CoV-2:Possible role in children with acute hepatitis of unknown origin

The UK raised an alert with the World Health Organization(WHO)in April 2022 concerning a significant surge in the num-ber of children diagnosed with acute hepatitis of unknown origin(AHUO).Despite an ongoing investigation attributing its etiology to adenovirus infection,the absence of adenovirus inclusions in liver biopsies and the remarkably low viral load raised doubts.Concurrently,reports of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infections in children coincided with the surge in acute hepatitis cases,prompting the need for a thorough examination of the poten-tial connection between current or past SARS-CoV-2 infections and pediatric hepatitis epidemics.Epidemiological data suggests that acute hepatitis is a notable manifestation of the multiple-system inflammatory syndrome in children following the global SARS-CoV-2 pandemic.However,the precise role of the SARS-CoV-2 virus in liver injury etiology remains uncertain.To shed light on the potential association between SARS-CoV-2 and AHUO in children,we conduct-ed a systematic review of epidemiological links,potential pathogenesis,and recent research findings,aiming to raise awareness and vigilance among clinicians.Convincing and definitive evidence will be essential in the future to confirm the direct impact of SARS-CoV-2 infection on children with AHUO.