tetano
Editor, Senior Moderator
Cell
. 2020 Sep 6;S0092-8674(20)31157-0.
doi: 10.1016/j.cell.2020.09.016. Online ahead of print.
The Immunology of Multisystem Inflammatory Syndrome in Children with COVID-19
Camila Rosat Consiglio[SUP] 1 [/SUP], Nicola Cotugno[SUP] 2 [/SUP], Fabian Sardh[SUP] 3 [/SUP], Christian Pou[SUP] 1 [/SUP], Donato Amodio[SUP] 2 [/SUP], Lucie Rodriguez[SUP] 1 [/SUP], Ziyang Tan[SUP] 1 [/SUP], Sonia Zicari[SUP] 4 [/SUP], Alessandra Ruggiero[SUP] 4 [/SUP], Giuseppe Rubens Pascucci[SUP] 4 [/SUP], Veronica Santilli[SUP] 5 [/SUP], Tessa Campbell[SUP] 6 [/SUP], Yenan Bryceson[SUP] 6 [/SUP], Daniel Eriksson[SUP] 7 [/SUP], Jun Wang[SUP] 1 [/SUP], Alessandra Marchesi[SUP] 8 [/SUP], Tadepally Lakshmikanth[SUP] 1 [/SUP], Andrea Campana[SUP] 8 [/SUP], Alberto Villani[SUP] 8 [/SUP], Paolo Rossi[SUP] 9 [/SUP], CACTUS Study Team; Nils Landegren[SUP] 10 [/SUP], Paolo Palma[SUP] 11 [/SUP], Petter Brodin[SUP] 12 [/SUP]
Affiliations
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is typically very mild and often asymptomatic in children. A complication is the rare multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19, presenting 4-6 weeks after infection as high fever, organ dysfunction, and strongly elevated markers of inflammation. The pathogenesis is unclear but has overlapping features with Kawasaki disease suggestive of vasculitis and a likely autoimmune etiology. We apply systems-level analyses of blood immune cells, cytokines, and autoantibodies in healthy children, children with Kawasaki disease enrolled prior to COVID-19, children infected with SARS-CoV-2, and children presenting with MIS-C. We find that the inflammatory response in MIS-C differs from the cytokine storm of severe acute COVID-19, shares several features with Kawasaki disease, but also differs from this condition with respect to T cell subsets, interleukin (IL)-17A, and biomarkers associated with arterial damage. Finally, autoantibody profiling suggests multiple autoantibodies that could be involved in the pathogenesis of MIS-C.
Keywords: COVID-19; IL-17A; Kawasaki disease; MIS-C; SARS-CoV-2; autoantibodies; hyperinflammation in children; multisystem inflammatory syndrome in children; systems immunology.
. 2020 Sep 6;S0092-8674(20)31157-0.
doi: 10.1016/j.cell.2020.09.016. Online ahead of print.
The Immunology of Multisystem Inflammatory Syndrome in Children with COVID-19
Camila Rosat Consiglio[SUP] 1 [/SUP], Nicola Cotugno[SUP] 2 [/SUP], Fabian Sardh[SUP] 3 [/SUP], Christian Pou[SUP] 1 [/SUP], Donato Amodio[SUP] 2 [/SUP], Lucie Rodriguez[SUP] 1 [/SUP], Ziyang Tan[SUP] 1 [/SUP], Sonia Zicari[SUP] 4 [/SUP], Alessandra Ruggiero[SUP] 4 [/SUP], Giuseppe Rubens Pascucci[SUP] 4 [/SUP], Veronica Santilli[SUP] 5 [/SUP], Tessa Campbell[SUP] 6 [/SUP], Yenan Bryceson[SUP] 6 [/SUP], Daniel Eriksson[SUP] 7 [/SUP], Jun Wang[SUP] 1 [/SUP], Alessandra Marchesi[SUP] 8 [/SUP], Tadepally Lakshmikanth[SUP] 1 [/SUP], Andrea Campana[SUP] 8 [/SUP], Alberto Villani[SUP] 8 [/SUP], Paolo Rossi[SUP] 9 [/SUP], CACTUS Study Team; Nils Landegren[SUP] 10 [/SUP], Paolo Palma[SUP] 11 [/SUP], Petter Brodin[SUP] 12 [/SUP]
Affiliations
- PMID: 32966765
- DOI: 10.1016/j.cell.2020.09.016
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is typically very mild and often asymptomatic in children. A complication is the rare multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19, presenting 4-6 weeks after infection as high fever, organ dysfunction, and strongly elevated markers of inflammation. The pathogenesis is unclear but has overlapping features with Kawasaki disease suggestive of vasculitis and a likely autoimmune etiology. We apply systems-level analyses of blood immune cells, cytokines, and autoantibodies in healthy children, children with Kawasaki disease enrolled prior to COVID-19, children infected with SARS-CoV-2, and children presenting with MIS-C. We find that the inflammatory response in MIS-C differs from the cytokine storm of severe acute COVID-19, shares several features with Kawasaki disease, but also differs from this condition with respect to T cell subsets, interleukin (IL)-17A, and biomarkers associated with arterial damage. Finally, autoantibody profiling suggests multiple autoantibodies that could be involved in the pathogenesis of MIS-C.
Keywords: COVID-19; IL-17A; Kawasaki disease; MIS-C; SARS-CoV-2; autoantibodies; hyperinflammation in children; multisystem inflammatory syndrome in children; systems immunology.
