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Scientists search for cause of hepatitis cases in children

BMJ 2022; 377 doi: (Published 14 April 2022) Cite this as: BMJ 2022;377:o982

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Re: Scientists search for cause of hepatitis cases in children

Dear Editor,

We read the recent article in The BMJ about rising cases of hepatitis in children and have deep concerns regarding thier timely identification, early diagnosis and initiation of treatment. We have strong reasons to believe that these cases might be due to a rise in newer variants of SARS-COV-2 in the affected regions in the recent times, and co-relation to recent COVID-19 infection in the close contacts and family is a must in such cases.

Our suggestions are based on recently published data regarding such cases of hepatitis in various parts of the globe; however, until recently such reports have failed to gather much attention. One such study performed in India recently found it to be related to a rise in the delta variant; hence the possibility of newer recombinants of other variants with delta or its interaction with other human viruses like adenovirus leading to such a situation needs urgent and thorough investigation.


1. Rawat SK, Asati AA, Jain A, Mishra N, Ratho RK. COVID-19 Associated Hepatitis in Children (CAH-C) during the second wave of SARS-CoV-2 infections in Central India: Is it a complication or transient phenomenon [Internet]. medRxiv; 2021 [cited 2022 Apr 20]. p. 2021.07.23.21260716. Available from:

2. Antala S, Diamond T, Kociolek LK, Shah AA, Chapin CA. Severe Hepatitis in Pediatric COVID-19. J Pediatr Gastroenterol Nutr. 2022 Feb 10. doi: 10.1097/MPG.0000000000003404. Epub ahead of print. PMID: 35149651.

Competing interests: No competing interests

21 April 2022
Dr R K Ratho (PGIMER, Chandigarh, India)
Bundelkhand Medical College, Sagar, India