| Literature DB >> 32730233 |
Caroline Diorio1,2, Sarah E Henrickson1,3, Laura A Vella1,4, Kevin O McNerney1,2, Julie Chase1,5, Chakkapong Burudpakdee1, Jessica H Lee1, Cristina Jasen1,3, Fran Balamuth6, David M Barrett1,2, Brenda L Banwell1,7, Kathrin M Bernt2, Allison M Blatz4, Kathleen Chiotos8, Brian T Fisher1,4, Julie C Fitzgerald8, Jeffrey S Gerber4, Kandace Gollomp1,9, Christopher Gray1, Stephan A Grupp2, Rebecca M Harris4, Todd J Kilbaugh8, Audrey R Odom John4, Michele Lambert1,9, Emily J Liebling5, Michele E Paessler1,10, Whitney Petrosa1, Charles Phillips2, Anne F Reilly1,2, Neil D Romberg1,3, Alix Seif1,2, Deborah A Sesok-Pizzini10, Kathleen E Sullivan1,3, Julie Vardaro11, Edward M Behrens1,5, David T Teachey1,2, Hamid Bassiri1,4.
Abstract
BACKGROUNDInitial reports from the severe acute respiratory coronavirus 2 (SARS-CoV-2) pandemic described children as being less susceptible to coronavirus disease 2019 (COVID-19) than adults. Subsequently, a severe and novel pediatric disorder termed multisystem inflammatory syndrome in children (MIS-C) emerged. We report on unique hematologic and immunologic parameters that distinguish between COVID-19 and MIS-C and provide insight into pathophysiology.METHODSWe prospectively enrolled hospitalized patients with evidence of SARS-CoV-2 infection and classified them as having MIS-C or COVID-19. Patients with COVID-19 were classified as having either minimal or severe disease. Cytokine profiles, viral cycle thresholds (Cts), blood smears, and soluble C5b-9 values were analyzed with clinical data.RESULTSTwenty patients were enrolled (9 severe COVID-19, 5 minimal COVID-19, and 6 MIS-C). Five cytokines (IFN-γ, IL-10, IL-6, IL-8, and TNF-α) contributed to the analysis. TNF-α and IL-10 discriminated between patients with MIS-C and severe COVID-19. The presence of burr cells on blood smears, as well as Cts, differentiated between patients with severe COVID-19 and those with MIS-C.CONCLUSIONPediatric patients with SARS-CoV-2 are at risk for critical illness with severe COVID-19 and MIS-C. Cytokine profiling and examination of peripheral blood smears may distinguish between patients with MIS-C and those with severe COVID-19.FUNDINGFinancial support for this project was provided by CHOP Frontiers Program Immune Dysregulation Team; National Institute of Allergy and Infectious Diseases; National Cancer Institute; the Leukemia and Lymphoma Society; Cookies for Kids Cancer; Alex's Lemonade Stand Foundation for Childhood Cancer; Children's Oncology Group; Stand UP 2 Cancer; Team Connor; the Kate Amato Foundations; Burroughs Wellcome Fund CAMS; the Clinical Immunology Society; the American Academy of Allergy, Asthma, and Immunology; and the Institute for Translational Medicine and Therapeutics.Entities:
Keywords: COVID-19; Cytokines
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Year: 2020 PMID： 32730233 PMCID： PMC7598044 DOI： 10.1172/JCI140970
Source DB: PubMed Journal: J Clin Invest ISSN： 0021-9738 Impact factor: 14.808