- Adriana Romaní Vidal1 , Aisling Vaughan2 , Francesco Innocenti1,3 , Soledad Colombe2 , Lina Nerlander1 , Natalia Rachwal1 , Bruno Christian Ciancio1 , Aikaterini Mougkou1 , Carlos Carvalho1 , Enrique Delgado1 , Piers Mook2 , Géraldine de Muylder4 , Michael Peeters5 , Tencho Tenev6 , Elitsa Golkocheva-Markova6 , Veronika Vorobieva Solholm Jensen7 , Anders Koch8 , Julie Figoni9 , Cécile Brouard9 , Georgia Nikolopoulou10 , Anastasia Zisouli10 , Niamh Murphy11 , Annemarie Broderick12 , Lital Goldberg13 , Rivka Rich13 , Lior Hecht Sagie13 , Maria Elena Tosti14 , Barbara Suligoi15 , Rosa Joosten16 , Roan Pijnacker16 , Ingvild Fjeldheim17 , Eli Heen17 , Małgorzata Stępień18 , Piotr Polański18 , Rui Tato Marinho19 , João Vieira Martins20 , Carmen Varela21 , Ana Avellón22 , Emmi Andersson23 , Marie Jansson Mörk23 , Sema Mandal24 , Conall Watson24 , Laura Coughlan24 , Meera Chand25 , Claire Neill26 , Declan T Bradley27 , Kathy Li28 , Maureen O’Leary29 , Neil McInnes30 , Christopher J Williams31 , Catherine Moore31 , Ardiana Gjini31 , Erika Duffell1 , Richard Pebody2
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.