Serologic and Cytokine Signatures in Children With Multisystem Inflammatory Syndrome and Coronavirus Disease 2019.

Autor: Lapp SA; Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA.; Children's Healthcare of Atlanta, Atlanta, Georgia, USA., Abrams J; COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA., Lu AT; Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA.; Children's Healthcare of Atlanta, Atlanta, Georgia, USA., Hussaini L; Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA.; Children's Healthcare of Atlanta, Atlanta, Georgia, USA., Kao CM; Department of Pediatrics, Washington University School of Medicine, St Louis, Missouri, USA., Hunstad DA; Department of Pediatrics, Washington University School of Medicine, St Louis, Missouri, USA., Rosenberg RB; Division of Pediatric Critical Care Medicine, Phoenix Children's Hospital, Phoenix, Arizona, USA.; Department of Child Health, University of Arizona, College of Medicine-Phoenix, Phoenix, Arizona, USA., Zafferani MJ; Division of Pediatric Critical Care Medicine, Phoenix Children's Hospital, Phoenix, Arizona, USA.; Department of Child Health, University of Arizona, College of Medicine-Phoenix, Phoenix, Arizona, USA., Ede KC; Department of Child Health, University of Arizona, College of Medicine-Phoenix, Phoenix, Arizona, USA.; Division of Pediatric Rheumatology, Phoenix Children's Hospital, Phoenix, Arizona, USA., Ballan W; Department of Child Health, University of Arizona, College of Medicine-Phoenix, Phoenix, Arizona, USA.; Pediatric Infectious Diseases, Phoenix Children's Hospital, Phoenix, Arizona, USA., Laham FR; Arnold Palmer Hospital for Children, Orlando, Florida, USA., Beltran Y; Arnold Palmer Hospital for Children, Orlando, Florida, USA., Hsiao HM; Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA.; Children's Healthcare of Atlanta, Atlanta, Georgia, USA., Sherry W; Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA.; Children's Healthcare of Atlanta, Atlanta, Georgia, USA., Jenkins E; Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA.; Children's Healthcare of Atlanta, Atlanta, Georgia, USA., Jones K; Children's Healthcare of Atlanta, Atlanta, Georgia, USA., Horner A; Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA.; Children's Healthcare of Atlanta, Atlanta, Georgia, USA., Brooks A; Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA.; Children's Healthcare of Atlanta, Atlanta, Georgia, USA., Bryant B; COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.; Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee, USA., Meng L; COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.; Apex Systems affiliated with General Dynamics Information Technology, Falls Church, Virginia, USA., Hammett TA; COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA., Oster ME; Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA.; Children's Healthcare of Atlanta, Atlanta, Georgia, USA.; COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA., Bamrah-Morris S; COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA., Godfred-Cato S; COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA., Belay E; COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia, USA., Chahroudi A; Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA.; Children's Healthcare of Atlanta, Atlanta, Georgia, USA., Anderson EJ; Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA.; Children's Healthcare of Atlanta, Atlanta, Georgia, USA.; Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA., Jaggi P; Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA.; Children's Healthcare of Atlanta, Atlanta, Georgia, USA., Rostad CA; Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA.; Children's Healthcare of Atlanta, Atlanta, Georgia, USA.
Jazyk: angličtina
Zdroj: Open forum infectious diseases [Open Forum Infect Dis] 2022 Feb 24; Vol. 9 (3), pp. ofac070. Date of Electronic Publication: 2022 Feb 24 (Print Publication: 2022).
DOI: 10.1093/ofid/ofac070
Abstrakt: Background: The serologic and cytokine responses of children hospitalized with multisystem inflammatory syndrome (MIS-C) vs coronavirus disease 2019 (COVID-19) are poorly understood.
Methods: We performed a prospective, multicenter, cross-sectional study of hospitalized children who met the Centers for Disease Control and Prevention case definition for MIS-C (n = 118), acute COVID-19 (n = 88), or contemporaneous healthy controls (n = 24). We measured severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike receptor-binding domain (RBD) immunoglobulin G (IgG) titers and cytokine concentrations in patients and performed multivariable analysis to determine cytokine signatures associated with MIS-C. We also measured nucleocapsid IgG and convalescent RBD IgG in subsets of patients.
Results: Children with MIS-C had significantly higher SARS-CoV-2 RBD IgG than children with acute COVID-19 (median, 2783 vs 146; P  < .001), and titers correlated with nucleocapsid IgG. For patients with MIS-C, RBD IgG titers declined in convalescence (median, 2783 vs 1135; P  = .010) in contrast to patients with COVID-19 (median, 146 vs 4795; P  < .001). MIS-C was characterized by transient acute proinflammatory hypercytokinemia, including elevated levels of interleukin (IL) 6, IL-10, IL-17A, and interferon gamma (IFN-γ). Elevation of at least 3 of these cytokines was associated with significantly increased prevalence of prolonged hospitalization ≥8 days (prevalence ratio, 3.29 [95% CI, 1.17-9.23]).
Conclusions: MIS-C was associated with high titers of SARS-CoV-2 RBD IgG antibodies and acute hypercytokinemia with IL-6, IL-10, IL-17A, and IFN-γ.
(© The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)
Databáze: MEDLINE
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