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Recurrent assessment of lymphocyte subsets in 32 patients with multisystem inflammatory syndrome in children (MIS-C).
Okarska-Napierala, Magdalena; Mandziuk, Joanna; Feleszko, Wojciech; Stelmaszczyk-Emmel, Anna; Panczyk, Mariusz; Demkow, Urszula; Kuchar, Ernest.
  • Okarska-Napierala M; Department of Pediatrics with Clinical Assessment Unit, Medical University of Warsaw, Warsaw, Poland.
  • Mandziuk J; Department of Pediatrics with Clinical Assessment Unit, Medical University of Warsaw, Warsaw, Poland.
  • Feleszko W; Department of Pediatric Pneumology and Allergy, Medical University of Warsaw, Warsaw, Poland.
  • Stelmaszczyk-Emmel A; Department of Laboratory Diagnostics and Clinical Immunology of Developmental Age, Medical University of Warsaw, Warsaw, Poland.
  • Panczyk M; Department of Education and Research in Health Sciences, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland.
  • Demkow U; Department of Laboratory Diagnostics and Clinical Immunology of Developmental Age, Medical University of Warsaw, Warsaw, Poland.
  • Kuchar E; Department of Pediatrics with Clinical Assessment Unit, Medical University of Warsaw, Warsaw, Poland.
Pediatr Allergy Immunol ; 32(8): 1857-1865, 2021 11.
Article in English | MEDLINE | ID: covidwho-1334510
ABSTRACT

BACKGROUND:

Lymphopenia is a hallmark of multisystem inflammatory syndrome in children (MIS-C). We aimed to characterize lymphocyte subsets' shifts and their correlations with other severity markers of MIS-C.

METHODS:

In this prospective cross-sectional study, we performed peripheral lymphocyte phenotyping in 32 patients with MIS-C. We analyzed lymphocyte subsets at three time points of the disease the acute (A), convalescent (B), and recovery (C) phases. Based on age-normalized lymphocyte counts, we distinguished two groups of patients "the mild" (higher lymphocyte counts) and "the severe" (lower lymphocyte counts). In addition, we examined differences between these groups regarding other severity markers.

RESULTS:

In phase A, 84% of children had lymphopenia. Decreased absolute counts of CD3, CD4, and CD8 cells were observed in, respectively, 88%, 72%, and 84% of patients. The natural killer cells were decreased in 63% and CD19 in 59% of children. "The severe" group had significantly higher procalcitonin and troponin I levels and lower platelets and albumin. Moreover, "the severe" group had hypotension more frequently (73% vs. 20%, p = .008). In phase B, all lymphocyte counts increased, and 32% of children had lymphocytosis. The increase of CD3, CD4, and CD8 counts correlated with some laboratory severity markers (hemoglobin, procalcitonin, D-dimer, lactate dehydrogenase, N-terminal prohormone of brain natriuretic peptide, albumin), but not with steroid use. In phase C, most children had normal lymphocyte counts.

CONCLUSIONS:

Substantial shifts in lymphocyte counts during MIS-C apply most to T lymphocytes and correlate with the disease severity markers, particularly hypotension prevalence. A proportion of children with MIS-C develops transient lymphocytosis during convalescence.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Lymphocyte Subsets / T-Lymphocyte Subsets / Systemic Inflammatory Response Syndrome Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Language: English Journal: Pediatr Allergy Immunol Journal subject: Allergy and Immunology / Pediatrics Year: 2021 Document Type: Article Affiliation country: Pai.13611

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Lymphocyte Subsets / T-Lymphocyte Subsets / Systemic Inflammatory Response Syndrome Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Language: English Journal: Pediatr Allergy Immunol Journal subject: Allergy and Immunology / Pediatrics Year: 2021 Document Type: Article Affiliation country: Pai.13611