Related Experiment Video
Updated: Sep 26, 2025
An In vitro Model to Study Immune Responses of Human Peripheral Blood Mononuclear Cells to Human Respiratory Syncytial Virus Infection
Published on: December 10, 2013
B-Cell Responses in Hospitalized Severe Acute Respiratory Syndrome Coronavirus 2-Infected Children With and Without
Nadine Peart Akindele1,2, Lisa Pieterse2, San Suwanmanee2
1Division of Pediatric Infectious Diseases, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Insights
Children with multisystem inflammatory syndrome (MIS-C) show a more mature antibody response to SARS-CoV-2 compared to those with COVID-19. This suggests MIS-C may be a post-infectious complication rather than an acute infection.
Area of Science:
- Immunology
- Pediatrics
- Infectious Diseases
Background:
- Multisystem inflammatory syndrome in children (MIS-C) is a serious complication of SARS-CoV-2 infection.
- Immune responses in MIS-C versus COVID-19 in children are not well understood.
Purpose of the Study:
- To longitudinally compare B cell phenotypes, antibody characteristics, and virus-specific antibody-secreting cells in children with MIS-C and COVID-19.
Main Methods:
- Longitudinal analysis of plasma anti-nucleocapsid (N) and spike (S) antibodies (amount and avidity).
- Flow cytometry to analyze B cell phenotypes.
- Quantification of virus-specific antibody-secreting cells in circulation.
Main Results:
- Higher N-specific IgG in MIS-C patients early after presentation.
- Antibody avidity maturation was limited in MIS-C during follow-up, unlike in COVID-19.
- Both groups exhibited waning B cells but sustained antibody-secreting cell production for months.
Conclusions:
- B cell responses were broadly similar between MIS-C and COVID-19 groups.
- MIS-C patients presented with a more mature antibody response, suggesting a post-infectious mechanism.
Abstract:
Multisystem inflammatory syndrome in children (MIS-C) can complicate infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), but differences in the immune responses during MIS-C compared to coronavirus disease 2019 (COVID-19) are poorly understood. We longitudinally compared the amounts and avidity of plasma anti-nucleocapsid (N) and spike (S) antibodies, phenotypes of B cells, and numbers of virus-specific antibody-secreting cells in circulation of children hospitalized with COVID-19 (n = 10) and with MIS-C (n = 12). N-specific immunoglobulin G (IgG) was higher early after presentation for MIS-C than COVID-19 patients and avidity of N- and S-specific IgG at presentation did not mature further during follow-up as it did for COVID-19. Both groups had waning proportions of B cells in circulation and decreasing but sustained production of virus-specific antibody-secreting cells for months. Overall, B-cell responses were similar, but those with MIS-C demonstrated a more mature antibody response at presentation compared to COVID-19, suggesting a postinfectious entity.
