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.

Consiglio, C.r., Cotugno, N., Sardh, F., Pou, C., Amodio, D., Rodriguez, L., et al. (2020). The Immunology of Multisystem Inflammatory Syndrome in Children with COVID-19. CELL, 183(4), 968-981 [10.1016/j.cell.2020.09.016].

The Immunology of Multisystem Inflammatory Syndrome in Children with COVID-19

Cotugno, Nicola;Amodio, Donato;Villani, Alberto;Rossi, Paolo;Palma, Paolo;
2020-01-01

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.
2020
Pubblicato
Rilevanza internazionale
Articolo
Esperti anonimi
Settore MED/38 - PEDIATRIA GENERALE E SPECIALISTICA
English
COVID-19; IL-17A; Kawasaki disease; MIS-C; SARS-CoV-2; autoantibodies; hyperinflammation in children; multisystem inflammatory syndrome in children; systems immunology; Autoantibodies; Betacoronavirus; Child; Child, Preschool; Coronavirus Infections; Cytokines; Female; Humans; Immunity, Humoral; Infant; Male; Mucocutaneous Lymph Node Syndrome; Pandemics; Pneumonia, Viral; Principal Component Analysis; Proteome; Severity of Illness Index; Systemic Inflammatory Response Syndrome; T-Lymphocyte Subsets
Consiglio, C.r., Cotugno, N., Sardh, F., Pou, C., Amodio, D., Rodriguez, L., et al. (2020). The Immunology of Multisystem Inflammatory Syndrome in Children with COVID-19. CELL, 183(4), 968-981 [10.1016/j.cell.2020.09.016].
Consiglio, Cr; Cotugno, N; Sardh, F; Pou, C; Amodio, D; Rodriguez, L; Tan, Z; Zicari, S; Ruggiero, A; Pascucci, Gr; Santilli, V; Campbell, T; Bryceson, Y; Eriksson, D; Wang, J; Marchesi, A; Lakshmikanth, T; Campana, A; Villani, A; Rossi, P; Landegren, N; Palma, P; Brodin, P
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/259394
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