tetano
Editor, Senior Moderator
J Infect Dis
. 2021 Aug 16;224(4):606-615.
doi: 10.1093/infdis/jiab285.
Distinct Cytokine and Chemokine Dysregulation in Hospitalized Children With Acute Coronavirus Disease 2019 and Multisystem Inflammatory Syndrome With Similar Levels of Nasopharyngeal Severe Acute Respiratory Syndrome Coronavirus 2 Shedding
Nadine Peart Akindele[SUP] 1 [/SUP], Theodore Kouo[SUP] 2 [/SUP], Andrew H Karaba[SUP] 3 [/SUP], Oren Gordon[SUP] 1 [/SUP], Katherine Z J Fenstermacher[SUP] 4 [/SUP], Jeanette Beaudry[SUP] 1 [/SUP], Jessica H Rubens[SUP] 1 [/SUP], Christine C Atik[SUP] 5 [/SUP], Weiqiang Zhou[SUP] 6 [/SUP], Hongkai Ji[SUP] 6 [/SUP], Xueting Tao[SUP] 7 [/SUP], Dhananjay Vaidya[SUP] 8 [/SUP], Heba Mostafa[SUP] 9 [/SUP], Patrizio Caturegli[SUP] 5 [/SUP], Paul W Blair[SUP] 3 [/SUP], Lauren Sauer[SUP] 4 [/SUP], Andrea L Cox[SUP] 3 [/SUP], Deborah Persaud[SUP] 1 5 10 [/SUP]
Affiliations
Abstract
Background: Multisystem inflammatory syndrome in children (MIS-C) is a severe clinical phenotype of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection that remains poorly understood.
Methods: Hospitalized children <18 years of age with suspected coronavirus disease 2019 (COVID-19) (N = 53) were recruited into a prospective cohort study; 32 had confirmed COVID-19, with 16 meeting the US Centers for Disease Control criteria for MIS-C. Differences in nasopharyngeal viral ribonucleic acid (RNA) levels, SARS-CoV-2 seropositivity, and cytokine/chemokine profiles were examined, including after adjustments for age and sex.
Results: The median ages for those with and without MIS-C were 8.7 years (interquartile range [IQR], 5.5-13.9) and 2.2 years (IQR, 1.1-10.5), respectively (P = .18), and nasopharyngeal levels of SARS-CoV-2 RNA did not differ significantly between the 2 groups (median 63 848.25 copies/mL versus 307.1 copies/mL, P = .66); 75% of those with MIS-C were antibody positive compared with 44% without (P = .026). Levels of 14 of 37 cytokines/chemokines (interleukin [IL]-1RA, IL-2RA, IL-6, IL-8, tumor necrosis factor-α, IL-10, IL-15, IL-18, monocyte chemoattractant protein [MCP]-1, IP-10, macrophage-inflammatory protein [MIP]-1α, MCP-2, MIP-1β, eotaxin) were significantly higher in children with MIS-C compared to those without, irrespective of age or sex (false discovery rate <0.05; P < .05).
Conclusions: The distinct pattern of heightened cytokine/chemokine dysregulation observed with MIS-C, compared with acute COVID-19, occurs across the pediatric age spectrum and with similar levels of nasopharyngeal SARS-CoV-2 RNA.
Keywords: COVID-19; MIS-C; SARS-CoV-2; coronavirus; viral RNA.
. 2021 Aug 16;224(4):606-615.
doi: 10.1093/infdis/jiab285.
Distinct Cytokine and Chemokine Dysregulation in Hospitalized Children With Acute Coronavirus Disease 2019 and Multisystem Inflammatory Syndrome With Similar Levels of Nasopharyngeal Severe Acute Respiratory Syndrome Coronavirus 2 Shedding
Nadine Peart Akindele[SUP] 1 [/SUP], Theodore Kouo[SUP] 2 [/SUP], Andrew H Karaba[SUP] 3 [/SUP], Oren Gordon[SUP] 1 [/SUP], Katherine Z J Fenstermacher[SUP] 4 [/SUP], Jeanette Beaudry[SUP] 1 [/SUP], Jessica H Rubens[SUP] 1 [/SUP], Christine C Atik[SUP] 5 [/SUP], Weiqiang Zhou[SUP] 6 [/SUP], Hongkai Ji[SUP] 6 [/SUP], Xueting Tao[SUP] 7 [/SUP], Dhananjay Vaidya[SUP] 8 [/SUP], Heba Mostafa[SUP] 9 [/SUP], Patrizio Caturegli[SUP] 5 [/SUP], Paul W Blair[SUP] 3 [/SUP], Lauren Sauer[SUP] 4 [/SUP], Andrea L Cox[SUP] 3 [/SUP], Deborah Persaud[SUP] 1 5 10 [/SUP]
Affiliations
- PMID: 34398245
- DOI: 10.1093/infdis/jiab285
Abstract
Background: Multisystem inflammatory syndrome in children (MIS-C) is a severe clinical phenotype of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection that remains poorly understood.
Methods: Hospitalized children <18 years of age with suspected coronavirus disease 2019 (COVID-19) (N = 53) were recruited into a prospective cohort study; 32 had confirmed COVID-19, with 16 meeting the US Centers for Disease Control criteria for MIS-C. Differences in nasopharyngeal viral ribonucleic acid (RNA) levels, SARS-CoV-2 seropositivity, and cytokine/chemokine profiles were examined, including after adjustments for age and sex.
Results: The median ages for those with and without MIS-C were 8.7 years (interquartile range [IQR], 5.5-13.9) and 2.2 years (IQR, 1.1-10.5), respectively (P = .18), and nasopharyngeal levels of SARS-CoV-2 RNA did not differ significantly between the 2 groups (median 63 848.25 copies/mL versus 307.1 copies/mL, P = .66); 75% of those with MIS-C were antibody positive compared with 44% without (P = .026). Levels of 14 of 37 cytokines/chemokines (interleukin [IL]-1RA, IL-2RA, IL-6, IL-8, tumor necrosis factor-α, IL-10, IL-15, IL-18, monocyte chemoattractant protein [MCP]-1, IP-10, macrophage-inflammatory protein [MIP]-1α, MCP-2, MIP-1β, eotaxin) were significantly higher in children with MIS-C compared to those without, irrespective of age or sex (false discovery rate <0.05; P < .05).
Conclusions: The distinct pattern of heightened cytokine/chemokine dysregulation observed with MIS-C, compared with acute COVID-19, occurs across the pediatric age spectrum and with similar levels of nasopharyngeal SARS-CoV-2 RNA.
Keywords: COVID-19; MIS-C; SARS-CoV-2; coronavirus; viral RNA.