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Children with Post COVID-19 Multisystem Inflammatory Syndrome Display Unique Pathophysiological Metabolic Phenotypes

Nathan G Lawler1, Lael M Yonker2,3, Samantha Lodge1

  • 1Australian National Phenome Center, and Center for Computational and Systems Medicine, Health Futures Institute, Murdoch University, Harry Perkins Building, Perth, Western Australia 6150, Australia.

Journal of Proteome Research
|June 9, 2025
PubMed

Insights

Children with COVID-19 and multisystem inflammatory syndrome (MIS-C) show distinct metabolic changes, particularly in lipids. These metabolic disruptions in pediatric COVID-19 mirror severe adult cases, suggesting shared inflammatory pathways and potential long-term health effects.

Area of Science:

  • Biochemistry
  • Pediatric Infectious Diseases
  • Metabolomics

Background:

  • SARS-CoV-2 infections in children range from mild to severe, including multisystem inflammatory syndrome in Children (MIS-C).
  • Understanding the metabolic impact of COVID-19 in pediatric populations is crucial for assessing long-term health consequences.

Purpose of the Study:

  • To investigate the distinct metabolic profiles of children with acute COVID-19 and MIS-C compared to healthy controls.
  • To identify specific metabolic alterations and inflammatory markers associated with SARS-CoV-2 infection in pediatric serum.

Main Methods:

  • Metabolic profiling of 147 children's serum samples (acute COVID-19, MIS-C, healthy controls).
  • Utilized nuclear magnetic resonance spectroscopy and liquid chromatography-mass spectrometry to measure 1101 metabolites.
  • Analyzed lipid classes, Apo-B100/Apo-A1 ratio, triglycerides, and inflammatory markers.

Main Results:

  • Distinct metabolic profiles were observed in acute COVID-19 and MIS-C patients, with significant lipid alterations.
  • Both groups showed an elevated Apo-B100/Apo-A1 ratio and increased serum inflammatory markers.
  • MIS-C patients exhibited unique disruptions, including elevated triglycerides and altered lipoprotein composition, mirroring severe adult COVID-19 metabolic disturbances.

Conclusions:

  • Pediatric COVID-19 and MIS-C induce significant metabolic disturbances, particularly in lipid metabolism.
  • The shared metabolic alterations with severe adult COVID-19 suggest a common inflammatory response pathway.
  • These findings highlight potential long-term health impacts and the need for further research into COVID-19's metabolic consequences in children.

Keywords:
SARS-CoV-2hyper-inflammationinflammationlipidslipoproteinsmass spectrometrynuclear magnetic resonance spectroscopyphenoconversion

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