Abstract
Background
Coronavirus disease 19 (COVID-19) may have a severe course in children. Multisystem inflammatory syndrome in children (MIS-C) is the post-COVID complication characterized by an exaggerated inflammation, observed in children. However, data on the underlying pathophysiology are sparse. We therefore aimed to assess the cytokine and chemokine profiles of children with MIS-C and compare these to life-threatening severe SARS-CoV-2 and healthy controls (HCs) to shed light on disease pathophysiology.
Methods
Samples of 31 children with MIS-C, 10 with severe/critical COVID-19 and 11 HCs were included. Cytokine and chemokine profiles were studied and compared in between groups.
Results
Most cytokines and chemokines related to IL-1 family and IFN-γ pathway (including IL-18 and MIG/CXCL9) and IL-17A were significantly higher in the MIS-C group when compared to the severe/critical COVID-19 group and HCs. IP-10/CXCL10 and IL-10 were higher in both MIS-C patients and severe/critical COVID-19 compared to HCs.
Conclusion
Our results suggest that IL-1 and IFN-γ pathways play an important role in the pathophysiology of MIS-C.
Impact
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This study defines a pattern of distinctive immune responses in children with MIS-C and in patients with severe/critical COVID-19.
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As the COVID-19 pandemic continues, biomarkers to identify MIS-C risk are needed to guide our management that study results may shed light on it.
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Data availability
The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.
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Funding
This work was supported by Hacettepe University Research Projects Department [THD‐2021‐19591]. Y.O., S.L.G., P.D.O., A.B.C. and S.O. received the grant.
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S.O., A.B.C. and Y.O. conceptualized and designed the study and reviewed and revised the manuscript. S.L.G. conceptualized the study, collected data, carried out the analyses and drafted the initial manuscript. E.S. performed laboratory analysis. P.D.O. collected data, carried out the analyses. J.K. performed statistical analysis. S.K., U.K.A., M.K.C., O.B. and S.G. collected data. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.
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This study complies with the Declaration of Helsinki, that Hacettepe University Ethical Committee has approved the research protocol [2021/09-45] and that informed consent has been obtained from the subjects (or their legally authorized representative).
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Gurlevik, S.L., Ozsurekci, Y., Sağ, E. et al. The difference of the inflammatory milieu in MIS-C and severe COVID-19. Pediatr Res 92, 1805–1814 (2022). https://doi.org/10.1038/s41390-022-02029-4
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DOI: https://doi.org/10.1038/s41390-022-02029-4
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