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Long-term outcomes and immune profiling in children with multisystem inflammatory syndrome (MIS-C)
Indira Jaxybayeva1, Riza Boranbayeva2, Minira Bulegenova3
1Asfendiyarov Kazakh National Medical University. ind.88@mail.ru.
Insights
Children with multisystem inflammatory syndrome (MIS-C) can experience long-term somatic disorders and immune changes. Most patients show subclinical heart issues within a year, indicating ongoing health impacts after MIS-C.
Area of Science:
- Pediatric Cardiology
- Immunology
- Infectious Diseases
Background:
- Follow-up data for multisystem inflammatory syndrome in children (MIS-C) is limited.
- Understanding long-term consequences is crucial for pediatric patient care.
Purpose of the Study:
- To investigate the long-term consequences in children who have undergone MIS-C.
- To identify specific somatic disorders and immune system changes post-MIS-C.
Main Methods:
- A retrospective study of 93 children with MIS-C, analyzing outcomes over periods up to 2+ years.
- Prospective immunophenotyping and cytokine analysis in 31 children during acute and post-discharge phases.
- Monitoring included outpatient events and cardiovascular system assessments.
Main Results:
- Common outpatient findings included pneumonia, somatic disorder syndrome, visual impairment, and joint damage.
- Cardiovascular changes observed included decreased heart dilatation and improved left ventricular function, but increased valve regurgitation and arrhythmias.
- Immune profiling revealed T-lymphocyte and NK-cell reconstitution, with specific alterations in B-cells and other immune markers.
Conclusions:
- Children with a history of MIS-C face diverse long-term somatic disorders and potential disease recurrence.
- Subclinical myocardial involvement is prevalent within the first year post-MIS-C.
- Altered immune cell expression, such as low CD95, may play a role in MIS-C pathogenesis.
Background And Aim:
Existing follow-up data after MIS-C is limited.
Purpose Of The Study:
to investigate the long-term consequences in children who have undergone MIS-C.
Methods:
The retrospective study included 93 children. The identified changes were divided into the following periods: occurred within first 6 months, 1 year, 2 years, and more than 2 years after MIS-C. Besides, 31 children underwent prospective immunophenotyping of peripheral blood and the determination of cytokines during the acute period of the disease and after discharge.
Results:
Outpatient monitoring events included pneumonia (9.6%), somatic disorder syndrome (11.8%), visual impairment (7.5%), joint damage (6.6%), weight changes (2.2%), and MIS-C recurrence (2.2%). A study of the cardiovascular system showed a statistically significant decrease in the frequency of the right and left heart dilatation, left ventricular dysfunction, pericarditis, pulmonary arterial hypertension, coronaritis, mitral regurgitation. But at the same time an increase in pulmonary and tricuspid valve regurgitation and arrhythmias compared with the acute period was detected. Most of the changes took place within first year of observation. Immune profiling showed reconstitution of CD3, CD4 T-lymphocytes, NK-cells, maintenance of a high relative value of CD8, reduction of CD19+ B-cells, expression of CD3-HLA-DR+, CD25, CD279, CD95.
Conclusions:
After the history of MIS-C, children in the long-term follow-up had various somatic disorders and disease recurrence. Most patients (64.1%) showed subclinical signs of myocardial involvement within first year of observation. Low expression of CD95 may justify an certain role in the pathogenesis of the disease.
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