Thread by @Rpshahmemorial1

Long Thread -1/n
There is a visible effort by some quarters to steer the discussion about Pediatric Liver Injuries away from Covid ( blame Lockdowns & Adeno) . So let's recap what we already know from SARS & MERS effects on the liver ctd)

2/n We know that the liver injury can be due to -direct viral replication, caused by poor blood flow ( hypoxia) , caused by ventilation ( In PICU) , Immune response, breakage of the gut vascular barrier and the alteration in the gut bacteria ( gut - liver axis) and drugs ctd)

3/n When you have 15% people have raised liver function tests in SARS , I think it is fool hardy to try and distract attention away from hepatic issues in Covid since SARS is the closest that we have and not Adeno dx.doi.org/10.1016%2Fj.am…

4/n This well done microscopic study from the SARS pandemic showed 2/7 cases which is close to 30% to have massive necrosis in liver and Cirrhosis-To now try and lay this on lockdown is laughable @Telegraph and exposes the bias that you have .

5/n ctd) another paper said that 60% had liver issues with SARS and interestingly report lymphocytic infiltration which can be due to Autoimmune Hepatitis , there is apoptosis ( programmed death of liver cells ) and mitosis ( effort by the liver to regenerate) post SARS ctd)

6/n ctd) The whole gamut of problems doesn't appear initially
24% people had liver issues on admission in hospital BUT over the course of the hospitalizations 69% developed these complications leading to desaturation ,need of ICU and death doi: 10.3748/wjg.v11.i14.2148
ctd)

7/n ctd) Have always said that we need to include the fecal sampling in RTPCR or RAT negatives, we know that this is common with Omicron , however SARS had 41% people with virus present in the liver, to try and paint it otherwise is deliberate misinformation ctd)

@RoopaDhatt @Gab_H_R @iamSandeepR @ProfAbdoolKarim @qhanlee @DecisionPark @epibuff @KellyQuilt @quant_aq @jpark731 8/n ctd) Most of these cases tend to be ignored in the normal clinic HOWEVER signs of abnormal ie more than 5 times SGOT / SGPT warrant closer attention , we know that most are mild initially and some 7- 10% would have progressed ctd)

9/n ctd) SARS was not alone in causing liver issues but the chance is approximately 3 times higher , to try and brush Covid under the carpet as a cause of liver injury in children is unethical , dangerous and deliberate misinformation.

10/n ctd) We know that with Covid the situation is a little different , the tropism is more on the colangiocytes less in the liver cells directly BUT often the immune issues & the endothelial dysfunction that is associated with other organs( and long Covid) are significant .

11/n The powers to be are worried and they understand that liver injury to kids could potentially upset the whole " Covid is no issue to kids " story, this #lockdown theory is trying to confuse the masses . I hope that we continue countering it well. 🙏🙏