Systemic Inflammation and Microbial Translocation Are Characteristic Features of SARS-CoV-2-Related Multisystem...

Area of Science:

• Pediatric Infectious Diseases
• Immunology
• Virology

Background:

• Multisystem inflammatory syndrome in children (MIS-C) is a rare but serious complication of SARS-CoV-2 infection.
• The detailed inflammatory mechanisms underlying MIS-C remain largely unexplored.

Purpose of the Study:

• To investigate the role of systemic inflammation and microbial translocation markers in children with MIS-C.
• To compare these markers in children with MIS-C, acute COVID-19, SARS-CoV-2 seropositivity, and healthy controls.

Main Methods:

• Plasma levels of acute phase proteins (e.g., CRP, α2M, SAP, Hp) and microbial translocation markers (e.g., LPS, sCD14, LBP) were measured.
• Statistical analyses and principal component analysis were employed to differentiate between groups.

Main Results:

• Children with MIS-C showed significantly elevated levels of CRP, α2M, SAP, LPS, sCD14, and LBP, and lower Hp levels compared to other groups.
• COVID-19 children also had higher marker levels than seropositive and control children.
• Principal component analysis effectively distinguished MIS-C and COVID-19 cases from seropositive and control children.

Conclusions:

• Systemic inflammation and microbial translocation are key features differentiating MIS-C and COVID-19 in children.
• These findings enhance understanding of the pathogenesis of diverse SARS-CoV-2 presentations in pediatric populations.