{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T23:46:49Z","timestamp":1788306409616,"version":"build-2803163510"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2020,10,27]],"date-time":"2020-10-27T00:00:00Z","timestamp":1603756800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2020,10,27]],"date-time":"2020-10-27T00:00:00Z","timestamp":1603756800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatology"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>A newly recognized multisystem inflammatory syndrome in children (MIS\u2010C) has had a paradigm\u2010shifting effect on the perception of severe acute respiratory syndrome, coronavirus\u20102 (SARS\u2010CoV\u20102) illness severity in children. We report the clinical and biochemical features of liver involvement, and the comorbidities that present with hepatitis, in a substantial cohort of patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Approach and Results<\/jats:title>\n                    <jats:p>\n                      This is a retrospective cohort study of 44 patients with MIS\u2010C admitted at Morgan Stanley Children\u2019s Hospital of New York\u2010Presbyterian during April and May 2020. We evaluated the number of patients who developed hepatitis and examined both demographics and inflammatory laboratory values to ascertain those that were at higher risk for liver involvement and more severe disease. Hepatitis was present in 19 subjects (43%) and was associated with more severe disease. Persons with hepatitis had significantly higher rates of shock at presentation (21.1% vs. 0%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0=\u00a00.008), greater respiratory support requirement (42.1% vs. 12%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0=\u00a00.005), and longer hospitalization times (median, 7 [interquartile range {IQR}, 5, 10] vs. 4\u00a0days [IQR, 3.5, 6.5];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0&lt;\u00a00.05). Patients with hepatitis also had significantly higher levels of ferritin (706.9 vs. 334.2\u00a0mg\/mL;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0&lt;\u00a00.01), interleukin\u20106 (233.9 vs. 174.7\u00a0pg\/mL;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0&lt;\u00a00.05), troponin (83.0 vs. 28.5\u00a0ng\/L;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0&lt;\u00a00.05), and B\u2010type natriuretic peptide (7,424.5 vs. 3,209.5\u00a0pg\/mL;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0&lt;\u00a00.05). The single patient with liver failure also developed multiorgan failure requiring vasopressors, hemodialysis, and mechanical ventilation. All patients were discharged, though &gt;50% had persistent hepatitis up to 1\u00a0month after discharge.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Hepatitis is common in children with MIS\u2010C and is associated with a more severe presentation and persistent elevation of liver function tests in many. Despite the positive outcomes reported here, close follow\u2010up is warranted given the limited knowledge of the long\u2010term impact of SARS\u2010CoV\u20102 on the liver.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hep.31526","type":"journal-article","created":{"date-parts":[[2020,8,28]],"date-time":"2020-08-28T07:41:20Z","timestamp":1598600480000},"page":"1522-1527","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":80,"title":["Acute Hepatitis Is a Prominent Presentation of the Multisystem Inflammatory Syndrome in Children: A Single\u2010Center Report"],"prefix":"10.1097","volume":"72","author":[{"given":"Amanda","family":"Cantor","sequence":"first","affiliation":[{"name":"Department of Pediatrics,Division of Pediatric Gastroenterology, Hepatology and Nutrition,Morgan Stanley Children\u2019s Hospital,Columbia University Irving Medical Center,New York,NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Pediatrics,Division of Pediatric Gastroenterology, Hepatology and Nutrition,Morgan Stanley Children\u2019s Hospital,Columbia University Irving Medical Center,New York,NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Zachariah","sequence":"additional","affiliation":[{"name":"Department of Pediatrics,Division of Pediatric Infectious Disease,Morgan Stanley Children\u2019s Hospital,Columbia University Irving Medical Center,New York,NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernardo","family":"DaSilva","sequence":"additional","affiliation":[{"name":"Vagelos College of Physicians and Surgeons,Columbia University,New York,NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kara","family":"Margolis","sequence":"additional","affiliation":[{"name":"Department of Pediatrics,Division of Pediatric Gastroenterology, Hepatology and Nutrition,Morgan Stanley Children\u2019s Hospital,Columbia University Irving Medical Center,New York,NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6128-0155","authenticated-orcid":false,"given":"Mercedes","family":"Martinez","sequence":"additional","affiliation":[{"name":"Department of Pediatrics,Division of Pediatric Gastroenterology, Hepatology and Nutrition,Morgan Stanley Children\u2019s Hospital,Columbia University Irving Medical Center,New York,NY"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,10,27]]},"reference":[{"key":"hep31526-bib-0001-20241017","doi-asserted-by":"crossref","first-page":"1663","DOI":"10.1056\/NEJMc2005073","article-title":"SARS\u2010CoV\u20102 infection in children","volume":"382","year":"2020","journal-title":"N Engl J Med"},{"key":"hep31526-bib-0002-20241017","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.1111\/apa.15270","article-title":"Systematic review of COVID\u201019 in children shows milder cases and a better prognosis than adults","volume":"109","year":"2020","journal-title":"Acta Paediatr"},{"key":"hep31526-bib-0004-20241017","doi-asserted-by":"crossref","first-page":"1771","DOI":"10.1016\/S0140-6736(20)31103-X","article-title":"An outbreak of severe Kawasaki\u2010like disease at the Italian epicentre of the SARS\u2010CoV\u20102 epidemic: an observational cohort study","volume":"395","year":"2020","journal-title":"Lancet"},{"key":"hep31526-bib-0006-20241017","article-title":"Multisystem inflammatory syndrome related to COVID\u201019 in previously healthy children and adolescents in New York City","year":"2020","journal-title":"JAMA"},{"key":"hep31526-bib-0007-20241017","article-title":"Acute heart failure in multisystem inflammatory syndrome in children (MIS\u2010C) in the context of global SARS\u2010CoV\u20102 pandemic","year":"2020","journal-title":"Circulation"},{"key":"hep31526-bib-0008-20241017","doi-asserted-by":"crossref","first-page":"998","DOI":"10.1111\/liv.14435","article-title":"Liver injury during highly pathogenic human coronavirus infections","volume":"40","year":"2020","journal-title":"Liver Int"},{"key":"hep31526-bib-0009-20241017","article-title":"A case of an Infant with SARS\u2010CoV\u20102 hepatitis early after liver transplantation","year":"2020","journal-title":"Pediatr 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stage","volume":"68","year":"2018","journal-title":"Hepatology"},{"key":"hep31526-bib-0013-20241017","article-title":"Clinical characteristics of 2019 novel coronavirus infection in China","year":"2020","journal-title":"N Engl J Med"},{"key":"hep31526-bib-0014-20241017","doi-asserted-by":"crossref","first-page":"58601","DOI":"10.18632\/oncotarget.17380","article-title":"Effect of hepatic steatosis on the progression of chronic hepatitis B: a prospective cohort and in vitro study","volume":"8","year":"2017","journal-title":"Oncotarget"},{"key":"hep31526-bib-0015-20241017","doi-asserted-by":"crossref","first-page":"1278","DOI":"10.1111\/liv.14470","article-title":"COVID\u201019 and liver disease","volume":"40","year":"2020","journal-title":"Liver Int"},{"key":"hep31526-bib-0016-20241017","doi-asserted-by":"crossref","first-page":"102763","DOI":"10.1016\/j.ebiom.2020.102763","article-title":"Longitudinal characteristics of lymphocyte responses and cytokine profiles in the peripheral blood 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