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Immunological features of the multisystem inflammatory syndrome associated with SARS-CoV-2 in children
Snezhina Lazova1,2, Dilyana Gerenska3, Yoanna Slabakova4
1Pediatric Department, University Hospital "N. I. Pirogov" General Eduard I. Totleben Blvd 21, 1606, Pette Kyosheta, Sofia, Bulgaria.
Insights
Multisystem inflammatory syndrome in children (MIS-C) involves severe inflammation linked to SARS-CoV-2. This review compares MIS-C, cytokine storm, and long COVID from an immunological perspective to aid diagnosis and treatment.
Area of Science:
- Pediatrics
- Immunology
- Infectious Diseases
Background:
- Severe multisystem inflammation, termed multisystem inflammatory syndrome in children (MIS-C), is associated with SARS-CoV-2 infection.
- Despite widely accepted definitions by CDC and WHO, a lack of international consensus complicates clinical diagnosis.
- MIS-C shares immunological and pathological features with cytokine storm, long COVID, and post-COVID syndromes, and also occurs in adults (MIS-A).
Purpose of the Study:
- To compare MIS-C, cytokine storm, long COVID, and MIS-A from an immunological viewpoint.
- To provide essential knowledge for pediatricians regarding the immunological basis of MIS-C for timely diagnosis and management.
- To highlight the need for further research into effective therapies and prophylactics.
Main Methods:
- Systematic review of published case reports, studies, systematic reviews, and meta-analyses.
- Comparative analysis of immunological and pathological features across related conditions.
- Literature synthesis to consolidate current understanding.
Main Results:
- Identified shared immunological and pathological characteristics between MIS-C and other post-COVID conditions.
- Highlighted the importance of understanding immunological underpinnings for clinical practice.
- Emphasized the need for further investigation into therapeutic and prophylactic strategies.
Conclusions:
- Understanding the immunological basis of MIS-C is crucial for pediatricians to ensure early recognition, diagnosis, and minimize systemic damage.
- Comparative immunological analysis is essential given the overlap with cytokine storm, long COVID, and MIS-A.
- Further research is required to develop optimal therapies and prophylactics for MIS-C and related conditions.
Abstract:
A particular group of children developed severe multisystem inflammation associated with current or recent SARS-CoV-2 infection or contact with a COVID-19 patient in the previous few weeks. The condition was defined as multisystem inflammatory syndrome (MIS) in children (MIS-C). As the definition of CDC and WHO is fast widely accepted, the lack of an international consensus on the definition of the syndrome cases, however, leads to some difficulties for clinicians. Additionally, MIS-C shares some immunological, pathological features with the conditions, such as cytokine storm, long COVID and/or post-COVID syndrome. The picture is further complicated by the existence of the syndrome in adults (MIS-A). Therefore, we have compared these conditions from the immunological point of view in our review based on the published case reports, studies, systematic reviews and metaanalyses. This knowledge is essential not only for immunologists. The paediatricians must be familiar with the immunological bases of the syndrome and implement it in on-time recognition and diagnosis and minimize systemic damage of this life-threatening condition at the earliest stage possible. Further investigations still need to be done to find and develop the best effective therapy and prophylactics.
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