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Multisystem inflammatory syndrome in children and COVID-19 are distinct presentations of SARS-CoV-2.
Diorio, Caroline; Henrickson, Sarah E; Vella, Laura A; McNerney, Kevin O; Chase, Julie; Burudpakdee, Chakkapong; Lee, Jessica H; Jasen, Cristina; Balamuth, Fran; Barrett, David M; Banwell, Brenda L; Bernt, Kathrin M; Blatz, Allison M; Chiotos, Kathleen; Fisher, Brian T; Fitzgerald, Julie C; Gerber, Jeffrey S; Gollomp, Kandace; Gray, Christopher; Grupp, Stephan A; Harris, Rebecca M; Kilbaugh, Todd J; John, Audrey R Odom; Lambert, Michele; Liebling, Emily J; Paessler, Michele E; Petrosa, Whitney; Phillips, Charles; Reilly, Anne F; Romberg, Neil D; Seif, Alix; Sesok-Pizzini, Deborah A; Sullivan, Kathleen E; Vardaro, Julie; Behrens, Edward M; Teachey, David T; Bassiri, Hamid.
  • Diorio C; Immune Dysregulation Frontier Program.
  • Henrickson SE; Division of Oncology.
  • Vella LA; Immune Dysregulation Frontier Program.
  • McNerney KO; Division of Allergy and Immunology.
  • Chase J; Immune Dysregulation Frontier Program.
  • Burudpakdee C; Division of Infectious Diseases.
  • Lee JH; Immune Dysregulation Frontier Program.
  • Jasen C; Division of Oncology.
  • Balamuth F; Immune Dysregulation Frontier Program.
  • Barrett DM; Division of Rheumatology.
  • Banwell BL; Immune Dysregulation Frontier Program.
  • Bernt KM; Immune Dysregulation Frontier Program.
  • Blatz AM; Immune Dysregulation Frontier Program.
  • Chiotos K; Division of Allergy and Immunology.
  • Fisher BT; Division of Emergency Medicine, and.
  • Fitzgerald JC; Immune Dysregulation Frontier Program.
  • Gerber JS; Division of Oncology.
  • Gollomp K; Immune Dysregulation Frontier Program.
  • Gray C; Division of Neurology, Department of Pediatrics.
  • Grupp SA; Division of Oncology.
  • Harris RM; Division of Infectious Diseases.
  • Kilbaugh TJ; Division of Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, and.
  • John ARO; Immune Dysregulation Frontier Program.
  • Lambert M; Division of Infectious Diseases.
  • Liebling EJ; Division of Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, and.
  • Paessler ME; Division of Infectious Diseases.
  • Petrosa W; Immune Dysregulation Frontier Program.
  • Phillips C; Division of Hematology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
  • Reilly AF; Immune Dysregulation Frontier Program.
  • Romberg ND; Division of Oncology.
  • Seif A; Division of Infectious Diseases.
  • Sesok-Pizzini DA; Division of Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, and.
  • Sullivan KE; Division of Infectious Diseases.
  • Vardaro J; Immune Dysregulation Frontier Program.
  • Behrens EM; Division of Hematology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
  • Teachey DT; Division of Rheumatology.
  • Bassiri H; Immune Dysregulation Frontier Program.
J Clin Invest ; 130(11): 5967-5975, 2020 11 02.
Article in English | MEDLINE | ID: covidwho-690425
Semantic information from SemMedBD (by NLM)
1. COVID-19 AFFECTS Child
Subject
COVID-19
Predicate
AFFECTS
Object
Child
2. Pediatric Disorder COEXISTS_WITH Congenital Hemidysplasia with Ichthyosiform Erythroderma and Limb Defects
Subject
Pediatric Disorder
Predicate
COEXISTS_WITH
Object
Congenital Hemidysplasia with Ichthyosiform Erythroderma and Limb Defects
3. Borg Category-Ratio 10 Perceived Exertion Score 5 COEXISTS_WITH Congenital Hemidysplasia with Ichthyosiform Erythroderma and Limb Defects
Subject
Borg Category-Ratio 10 Perceived Exertion Score 5
Predicate
COEXISTS_WITH
Object
Congenital Hemidysplasia with Ichthyosiform Erythroderma and Limb Defects
4. Congenital Hemidysplasia with Ichthyosiform Erythroderma and Limb Defects PROCESS_OF hospitalized patients
Subject
Congenital Hemidysplasia with Ichthyosiform Erythroderma and Limb Defects
Predicate
PROCESS_OF
Object
hospitalized patients
5. COVID-19 PROCESS_OF hospitalized patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
hospitalized patients
6. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
7. Congenital Hemidysplasia with Ichthyosiform Erythroderma and Limb Defects PROCESS_OF Patients
Subject
Congenital Hemidysplasia with Ichthyosiform Erythroderma and Limb Defects
Predicate
PROCESS_OF
Object
Patients
8. blood smear test DIAGNOSES Congenital Hemidysplasia with Ichthyosiform Erythroderma and Limb Defects
Subject
blood smear test
Predicate
DIAGNOSES
Object
Congenital Hemidysplasia with Ichthyosiform Erythroderma and Limb Defects
9. COVID-19 AFFECTS Child
Subject
COVID-19
Predicate
AFFECTS
Object
Child
10. Pediatric Disorder COEXISTS_WITH Congenital Hemidysplasia with Ichthyosiform Erythroderma and Limb Defects
Subject
Pediatric Disorder
Predicate
COEXISTS_WITH
Object
Congenital Hemidysplasia with Ichthyosiform Erythroderma and Limb Defects
11. Borg Category-Ratio 10 Perceived Exertion Score 5 COEXISTS_WITH Congenital Hemidysplasia with Ichthyosiform Erythroderma and Limb Defects
Subject
Borg Category-Ratio 10 Perceived Exertion Score 5
Predicate
COEXISTS_WITH
Object
Congenital Hemidysplasia with Ichthyosiform Erythroderma and Limb Defects
12. Congenital Hemidysplasia with Ichthyosiform Erythroderma and Limb Defects PROCESS_OF hospitalized patients
Subject
Congenital Hemidysplasia with Ichthyosiform Erythroderma and Limb Defects
Predicate
PROCESS_OF
Object
hospitalized patients
13. COVID-19 PROCESS_OF hospitalized patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
hospitalized patients
14. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
15. Congenital Hemidysplasia with Ichthyosiform Erythroderma and Limb Defects PROCESS_OF Patients
Subject
Congenital Hemidysplasia with Ichthyosiform Erythroderma and Limb Defects
Predicate
PROCESS_OF
Object
Patients
16. blood smear test DIAGNOSES Congenital Hemidysplasia with Ichthyosiform Erythroderma and Limb Defects
Subject
blood smear test
Predicate
DIAGNOSES
Object
Congenital Hemidysplasia with Ichthyosiform Erythroderma and Limb Defects
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.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Complement Membrane Attack Complex / Cytokines / Coronavirus Infections / Systemic Inflammatory Response Syndrome / Pandemics / Betacoronavirus Type of study: Observational study / Risk factors Limits: Adolescent / Child / Child, preschool / Female / Humans / Male Language: English Journal: J Clin Invest Year: 2020 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Complement Membrane Attack Complex / Cytokines / Coronavirus Infections / Systemic Inflammatory Response Syndrome / Pandemics / Betacoronavirus Type of study: Observational study / Risk factors Limits: Adolescent / Child / Child, preschool / Female / Humans / Male Language: English Journal: J Clin Invest Year: 2020 Document Type: Article