European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.
World Health Organization Regional Office for Europe, Copenhagen, Denmark.
Euro Surveill. 2022 Aug;27(31). doi: 10.2807/1560-7917.ES.2022.27.31.2200483.
Following the report of an excess in paediatric cases of severe acute hepatitis of unknown aetiology by the United Kingdom (UK) on 5 April 2022, 427 cases were reported from 20 countries in the World Health Organization European Region to the European Surveillance System TESSy from 1 January 2022 to 16 June 2022. Here, we analysed demographic, epidemiological, clinical and microbiological data available in TESSy. Of the reported cases, 77.3% were 5 years or younger and 53.5% had a positive test for adenovirus, 10.4% had a positive RT-PCR for SARS-CoV-2 and 10.3% were coinfected with both pathogens. Cases with adenovirus infections were significantly more likely to be admitted to intensive care or high-dependency units (OR = 2.11; 95% CI: 1.18-3.74) and transplanted (OR = 3.36; 95% CI: 1.19-9.55) than cases with a negative test result for adenovirus, but this was no longer observed when looking at this association separately between the UK and other countries. Aetiological studies are needed to ascertain if adenovirus plays a role in this possible emergence of hepatitis cases in children and, if confirmed, the mechanisms that could be involved.
继英国（UK）于 2022 年 4 月 5 日报告一起不明病因的小儿严重急性肝炎病例后，2022 年 1 月 1 日至 2022 年 6 月 16 日，世界卫生组织欧洲区域的欧洲监测系统 TESSy 共收到来自 20 个国家的 427 例病例报告。在此，我们对 TESSy 中可用的人口统计学、流行病学、临床和微生物学数据进行了分析。报告的病例中，77.3%为 5 岁或以下儿童，53.5%腺病毒检测呈阳性，10.4%新冠病毒 SARS-CoV-2 RT-PCR 检测呈阳性，10.3%同时感染两种病原体。腺病毒感染病例更有可能入住重症监护病房或高度依赖病房（OR=2.11；95%CI：1.18-3.74）和接受移植（OR=3.36；95%CI：1.19-9.55），而腺病毒检测结果为阴性的病例则不太可能出现这种情况，但当单独观察英国和其他国家之间的这种关联时，这种情况就不再存在。需要进行病因学研究以确定腺病毒是否在此次儿童肝炎病例的可能出现中发挥作用，如果得到证实，还需要确定可能涉及的机制。
