We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Multisystem inflammatory syndrome in children and COVID-19 are distinct presentations of SARS-CoV-2.
- Authors
Diorio, Caroline; Henrickson, Sarah E.; Vella, Laura A.; McNerney, Kevin O.; Chase, Julie; Burudpakdee, Chakkapong; Lee, Jessica H.; Jasen, Cristina; Balamuth, Fran; Barrett, David M.; Banwell, Brenda L.; Bernt, Kathrin M.; Blatz, Allison M.; Chiotos, Kathleen; Fisher, Brian T.; Fitzgerald, Julie C.; Gerber, Jeffrey S.; Gollomp, Kandace; Gray, Christopher; Grupp, Stephan A.
- Abstract
BACKGROUNDInitial reports from the severe acute respiratory coronavirus 2 (SARS-CoV-2) pandemic described children as being less susceptible to coronavirus disease 2019 (COVID-19) than adults. Subsequently, a severe and novel pediatric disorder termed multisystem inflammatory syndrome in children (MIS-C) emerged. We report on unique hematologic and immunologic parameters that distinguish between COVID-19 and MIS-C and provide insight into pathophysiology.METHODSWe prospectively enrolled hospitalized patients with evidence of SARS-CoV-2 infection and classified them as having MIS-C or COVID-19. Patients with COVID-19 were classified as having either minimal or severe disease. Cytokine profiles, viral cycle thresholds (Cts), blood smears, and soluble C5b-9 values were analyzed with clinical data.RESULTSTwenty patients were enrolled (9 severe COVID-19, 5 minimal COVID-19, and 6 MIS-C). Five cytokines (IFN-γ, IL-10, IL-6, IL-8, and TNF-α) contributed to the analysis. TNF-α and IL-10 discriminated between patients with MIS-C and severe COVID-19. The presence of burr cells on blood smears, as well as Cts, differentiated between patients with severe COVID-19 and those with MIS-C.CONCLUSIONPediatric patients with SARS-CoV-2 are at risk for critical illness with severe COVID-19 and MIS-C. Cytokine profiling and examination of peripheral blood smears may distinguish between patients with MIS-C and those with severe COVID-19.FUNDINGFinancial support for this project was provided by CHOP Frontiers Program Immune Dysregulation Team; National Institute of Allergy and Infectious Diseases; National Cancer Institute; the Leukemia and Lymphoma Society; Cookies for Kids Cancer; Alex's Lemonade Stand Foundation for Childhood Cancer; Children's Oncology Group; Stand UP 2 Cancer; Team Connor; the Kate Amato Foundations; Burroughs Wellcome Fund CAMS; the Clinical Immunology Society; the American Academy of Allergy, Asthma, and Immunology; and the Institute for Translational Medicine and Therapeutics.
- Subjects
NATIONAL Institute of Allergy &; Infectious Diseases (U.S.); COVID-19; SARS-CoV-2; COMMUNICABLE diseases; SYNDROMES; INTERLEUKIN-6; CYTOKINES; VIRAL pneumonia; RESEARCH; COMPLEMENT (Immunology); CLINICAL trials; RESEARCH methodology; SYSTEMIC inflammatory response syndrome; EVALUATION research; MEDICAL cooperation; SEVERITY of illness index; COMPARATIVE studies; EPIDEMICS; RESEARCH funding; LONGITUDINAL method
- Publication
Journal of Clinical Investigation, 2020, Vol 130, Issue 11, p5967
- ISSN
0021-9738
- Publication type
journal article
- DOI
10.1172/JCI140970