tetano
Editor, Senior Moderator
J Infect Dis
. 2021 May 24;jiab285.
doi: 10.1093/infdis/jiab285. Online ahead of print.
Distinct Cytokine and Chemokine Dysregulation in Hospitalized Children with Acute COVID-19 and Multisystem Inflammatory Syndrome with Similar Levels of Nasopharyngeal SARS-CoV-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 SARS-CoV-2 infection that remains poorly understood.
Methods: Hospitalized children <18 years of age with suspected COVID-19 (N=53) were recruited into a prospective cohort study; 32 had confirmed COVID-19, with 16 meeting the U.S. Centers for Disease Control criteria for MIS-C. Differences in nasopharyngeal viral 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 (IQR 5.5-13.9) and 2.2 years (IQR 1.1-10.5), respectively, (p=0.18) and nasopharyngeal levels of SARS-CoV-2 RNA did not differ significantly between the two groups (median 63,848.25 copies/mL versus 307.1 copies/mL, p= 0.66); 75% of those with MIS-C were antibody positive compared to 44% without, p=0.026. Levels of 14 of 37 cytokines/chemokines (IL-1RA, IL-2RA, IL-6, IL-8, TNF-α, IL-10, IL-15, IL-18, MCP-1, IP-10, MIP-1α, MCP-2, MIP-1β, Eotaxin) were significantly higher in children with MIS-C compared to those without, irrespective of age or sex (FDR<0.05; p<0.05).
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; Coronavirus; MIS-A; MIS-C; SARS-CoV-2; viral RNA.
. 2021 May 24;jiab285.
doi: 10.1093/infdis/jiab285. Online ahead of print.
Distinct Cytokine and Chemokine Dysregulation in Hospitalized Children with Acute COVID-19 and Multisystem Inflammatory Syndrome with Similar Levels of Nasopharyngeal SARS-CoV-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: 34036329
- DOI: 10.1093/infdis/jiab285
Abstract
Background: Multisystem Inflammatory Syndrome in Children (MIS-C) is a severe clinical phenotype of SARS-CoV-2 infection that remains poorly understood.
Methods: Hospitalized children <18 years of age with suspected COVID-19 (N=53) were recruited into a prospective cohort study; 32 had confirmed COVID-19, with 16 meeting the U.S. Centers for Disease Control criteria for MIS-C. Differences in nasopharyngeal viral 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 (IQR 5.5-13.9) and 2.2 years (IQR 1.1-10.5), respectively, (p=0.18) and nasopharyngeal levels of SARS-CoV-2 RNA did not differ significantly between the two groups (median 63,848.25 copies/mL versus 307.1 copies/mL, p= 0.66); 75% of those with MIS-C were antibody positive compared to 44% without, p=0.026. Levels of 14 of 37 cytokines/chemokines (IL-1RA, IL-2RA, IL-6, IL-8, TNF-α, IL-10, IL-15, IL-18, MCP-1, IP-10, MIP-1α, MCP-2, MIP-1β, Eotaxin) were significantly higher in children with MIS-C compared to those without, irrespective of age or sex (FDR<0.05; p<0.05).
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; Coronavirus; MIS-A; MIS-C; SARS-CoV-2; viral RNA.