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Quantitative SARS-CoV-2 Serology in Children With Multisystem Inflammatory Syndrome (MIS-C)
Christina A Rostad1,2, Ann Chahroudi1,3,2, Grace Mantus1,2
1Department of Pediatrics, Emory University and Children's Healthcare of Atlanta, Atlanta, Georgia.
Pediatrics
|September 4, 2020
Summary
Children with multisystem inflammatory syndrome in children (MIS-C) exhibit significantly higher SARS-CoV-2 antibody titers than those with COVID-19, Kawasaki disease, or controls. Serological responses in MIS-C correlate with disease severity and duration.
Area of Science:
- Pediatric Immunology
- Infectious Diseases
- Viral Serology
Background:
- Multisystem inflammatory syndrome in children (MIS-C) is a rare but serious condition linked to SARS-CoV-2 infection.
- Distinguishing MIS-C from other pediatric inflammatory conditions like Kawasaki disease (KD) is crucial for appropriate management.
- Understanding the specific serological profile of MIS-C can aid in diagnosis and risk stratification.
Purpose of the Study:
- To compare severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) serological responses in children with MIS-C versus those with COVID-19, KD, and healthy controls.
- To evaluate the correlation between SARS-CoV-2 antibody titers and clinical parameters in MIS-C.
- To assess the potential role of quantitative serology in diagnosing MIS-C.
Main Methods:
- Prospective identification and blood sample collection from hospitalized children with MIS-C, COVID-19, KD, and controls.
- Quantitative measurement of SARS-CoV-2 specific antibodies (IgM, IgG, neutralizing) using ELISAs and live-virus assays.
- Statistical comparison of antibody titers and correlation analyses with clinical data.
Main Results:
- Children with MIS-C demonstrated significantly higher SARS-CoV-2 RBD IgG antibody titers compared to all other groups (P < .001).
- MIS-C patients had detectable RBD IgM antibodies, indicating recent infection, and strong correlations between various SARS-CoV-2 antibody types.
- RBD IgG titers correlated with inflammatory markers (ESR) and length of hospital/ICU stay.
Conclusions:
- Quantitative SARS-CoV-2 serology can help diagnose MIS-C and differentiate it from similar pediatric conditions.
- Serological profiles may assist in stratifying risk for adverse outcomes in children with MIS-C.
- Elevated SARS-CoV-2 antibody titers are a key feature distinguishing MIS-C.
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