Inflammatory responses in SARS-CoV-2 associated multisystem inflammatory syndrome and Kawasaki Disease in children: an observational study

Biesbroek, G.; Kapitein, B.; Kuipers, I.M.; Gruppen, M.P.; Stijn, D. van; Peros, T.E.; Veenendaal, M. van; Jansen, M.H.A.; Zee, C.W. van der; Kuip, M. van der; Asmuth, E.G.J. von; Mooij, M.G.; Boer, M.E.J. den; Landman, G.W.; Houten, M.A. van; Schonenberg-Meinema, D.; Furth, A.M.T. van; Hensbroek, M.B. van; Scherpbier, H.; Meijgaarden, K.E. van; Ottenhoff, T.H.M.; Joosten, S.A.; Ketharanathan, N.; Blink, M.; Brackel, C.L.H.; Zaaijer, H.L.; Hombrink, P.; Berg, J.M. van den; Buddingh, E.P.; Kuijpers, T.W.

doi:doi:c

Multisystem Inflammatory Syndrome in Children (MIS-C) is a severe inflammatory disease in children related to SARS-CoV-2 with multisystem involvement including marked cardiac dysfunction and clinical symptoms that can resemble Kawasaki Disease (KD). We hypothesized that MIS-C and KD might have commonalities as well as unique inflammatory responses and studied these responses in both diseases. In total, fourteen children with MIS-C (n=8) and KD (n=6) were included in the period of March-June 2020. Clinical and routine blood parameters, cardiac follow-up, SARS-CoV-2-specific antibodies and CD4+ T-cell responses, and cytokine-profiles were determined in both groups. In contrast to KD patients, all MIS-C patients had positive Spike protein-specific CD3(+) CD4(+) T-cell responses. MIS-C and KD patients displayed marked hyper-inflammation with high expression of serum cytokines, including the drug-targetable interleukin (IL)-6 and IFN-gamma associated chemokines CXCL9, 10 and 11, which...Show moreMultisystem Inflammatory Syndrome in Children (MIS-C) is a severe inflammatory disease in children related to SARS-CoV-2 with multisystem involvement including marked cardiac dysfunction and clinical symptoms that can resemble Kawasaki Disease (KD). We hypothesized that MIS-C and KD might have commonalities as well as unique inflammatory responses and studied these responses in both diseases. In total, fourteen children with MIS-C (n=8) and KD (n=6) were included in the period of March-June 2020. Clinical and routine blood parameters, cardiac follow-up, SARS-CoV-2-specific antibodies and CD4+ T-cell responses, and cytokine-profiles were determined in both groups. In contrast to KD patients, all MIS-C patients had positive Spike protein-specific CD3(+) CD4(+) T-cell responses. MIS-C and KD patients displayed marked hyper-inflammation with high expression of serum cytokines, including the drug-targetable interleukin (IL)-6 and IFN-gamma associated chemokines CXCL9, 10 and 11, which decreased at follow-up. No statistical differences were observed between groups. Clinical outcomes were all favourable without cardiac sequelae at 6 months follow-up. In conclusion, MIS-C and KD-patients both displayed cytokine-associated hyper-inflammation with several high levels of drug-targetable cytokines.Show less

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Inflammatory responses in SARS-CoV-2 associated multisystem inflammatory syndrome and Kawasaki Disease in children: an observational study