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Plasma biomarker profiling of PIMS-TS, COVID-19 and SARS-CoV2 seropositive children - a cross-sectional observational study from southern India.
Venkataraman, Aishwarya; Kumar, Nathella Pavan; Hanna, Luke Elizabeth; Putlibai, Sulochana; Karthick, M; Rajamanikam, Anuradha; Sadasivam, Kalaimaran; Sundaram, Balasubramanian; Babu, Subash.
  • Venkataraman A; ICMR-National Institute for Research in Tuberculosis, Chennai, India; Kanchi Kamakoti CHILDS Trust Hospital, Chennai, India. Electronic address: avenkataraman@nhs.net.
  • Kumar NP; ICMR-National Institute for Research in Tuberculosis, Chennai, India. Electronic address: pavankumarn@nirt.res.in.
  • Hanna LE; ICMR-National Institute for Research in Tuberculosis, Chennai, India.
  • Putlibai S; Kanchi Kamakoti CHILDS Trust Hospital, Chennai, India.
  • Karthick M; ICMR-National Institute for Research in Tuberculosis, Chennai, India.
  • Rajamanikam A; National Institutes of Health-National Institute for Research in Tuberculosis - International Center for Excellence in Research, Chennai, India.
  • Sadasivam K; Kanchi Kamakoti CHILDS Trust Hospital, Chennai, India.
  • Sundaram B; Kanchi Kamakoti CHILDS Trust Hospital, Chennai, India.
  • Babu S; National Institutes of Health-National Institute for Research in Tuberculosis - International Center for Excellence in Research, Chennai, India; LPD, NIAID, NIH, Bethesda, MD, United States.
EBioMedicine ; 66: 103317, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1163669
ABSTRACT

BACKGROUND:

SARS-CoV-2 infection in children can present with varied clinical phenotypes and understanding the pathogenesis is essential, to inform about the clinical trajectory and management.

METHODS:

We performed a multiplex immune assay analysis and compared the plasma biomarkers of Paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 infection (PIMS-TS), acute COVID-19 infection (COVID-19), SARS-CoV-2 seropositive and control children admitted to a tertiary care children's hospital in Chennai, India. Pro-inflammatory cytokines, chemokines and growth factors were correlated with SARS-CoV-2 clinical phenotypes.

FINDINGS:

PIMS-TS children had significantly elevated levels of cytokines, IFNγ, IL-2, TNFα, IL-1α, IFNα, IFNß, IL-6, IL-15, IL-17A, GM-CSF, IL-10, IL-33 and IL-Ra; elevated chemokines, CCL2, CCL19, CCL20 and CXCL10 and elevated VEGF, Granzyme B and PDL-1 in comparison to COVID-19, seropositive and controls. COVID-19 children had elevated levels of IFNγ, IL-2, TNFα, IL-1α, IFNα, IFNß, IL-6, IL-17A, IL-10, CCL2, CCL5, CCL11, CXCL10 and VEGF in comparison to seropositive and/or controls. Similarly, seropositive children had elevated levels of IFNγ, IL-2, IL-1α, IFNß, IL-17A, IL-10, CCL5 and CXCL10 in comparison to control children. Plasma biomarkers in PIMS-TS and COVID-19 children showed a positive correlation with CRP and a negative correlation with the lymphocyte count and sodium levels.

INTERPRETATION:

We describe a comprehensive plasma biomarker profile of children with different clinical spectrum of SARS-CoV-2 infection from a low- and middle-income country (LMIC) and observed that PIMS-TS is a distinct and unique immunopathogenic paediatric illness related to SARS-CoV-2 presenting with cytokine storm different from acute COVID-19 infection and other hyperinflammatory conditions.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Biomarkers / Systemic Inflammatory Response Syndrome / COVID-19 Type of study: Observational study / Prognostic study / Randomized controlled trials Limits: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male Country/Region as subject: Asia Language: English Journal: EBioMedicine Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Biomarkers / Systemic Inflammatory Response Syndrome / COVID-19 Type of study: Observational study / Prognostic study / Randomized controlled trials Limits: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male Country/Region as subject: Asia Language: English Journal: EBioMedicine Year: 2021 Document Type: Article