Article ; Online: Deep immune profiling of MIS-C demonstrates marked but transient immune activation compared to adult and pediatric COVID-19.
Science immunology
2021 Volume 6, Issue 57
Abstract: ... The immune features of MIS-C compared to pediatric COVID-19 or adult disease remain poorly understood ... pediatric COVID-19) and patients with MIS-C. MIS-C patients had patterns of T cell-biased lymphopenia and T ... COVID-19 patients with acute respiratory distress syndrome (ARDS) had sustained immune activation, MIS-C ...
Abstract | Pediatric COVID-19 following SARS-CoV-2 infection is associated with fewer hospitalizations and often milder disease than in adults. A subset of children, however, present with Multisystem Inflammatory Syndrome in Children (MIS-C) that can lead to vascular complications and shock, but rarely death. The immune features of MIS-C compared to pediatric COVID-19 or adult disease remain poorly understood. We analyzed peripheral blood immune responses in hospitalized SARS-CoV-2 infected pediatric patients (pediatric COVID-19) and patients with MIS-C. MIS-C patients had patterns of T cell-biased lymphopenia and T cell activation similar to severely ill adults, and all patients with MIS-C had SARS-CoV-2 spike-specific antibodies at admission. A distinct feature of MIS-C patients was robust activation of vascular patrolling CX3CR1+ CD8+ T cells that correlated with the use of vasoactive medication. Finally, whereas pediatric COVID-19 patients with acute respiratory distress syndrome (ARDS) had sustained immune activation, MIS-C patients displayed clinical improvement over time, concomitant with decreasing immune activation. Thus, non-MIS-C versus MIS-C SARS-CoV-2 associated illnesses are characterized by divergent immune signatures that are temporally distinct from one another and implicate CD8+ T cells in the clinical presentation and trajectory of MIS-C. |
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MeSH term(s) | Adolescent ; Adult ; Aging/immunology ; COVID-19/immunology ; Child ; Child, Preschool ; Female ; Flow Cytometry ; Humans ; Leukopenia/immunology ; Lymphocyte Activation ; Male ; Systemic Inflammatory Response Syndrome/immunology ; T-Lymphocytes/immunology ; Young Adult |
Language | English |
Publishing date | 2021-03-30 |
Publishing country | United States |
Document type | Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't |
ISSN | 2470-9468 |
ISSN (online) | 2470-9468 |
DOI | 10.1126/sciimmunol.abf7570 |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
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