PLoS ONE (Jan 2022)

Inflammatory responses in SARS-CoV-2 associated Multisystem Inflammatory Syndrome and Kawasaki Disease in children: An observational study.

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

DOI
https://doi.org/10.1371/journal.pone.0266336
Journal volume & issue
Vol. 17, no. 11
p. e0266336

Abstract

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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-γ 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.