Author: Vella, Laura A.; Giles, Josephine R.; Baxter, Amy E.; Oldridge, Derek A.; Diorio, Caroline; Kuri-Cervantes, Leticia; Alanio, Cécile; Pampena, M. Betina; Wu, Jennifer E.; Chen, Zeyu; Huang, Yinghui Jane; Anderson, Elizabeth M.; Gouma, Sigrid; McNerney, Kevin O.; Chase, Julie; Burudpakdee, Chakkapong; Lee, Jessica H.; Apostolidis, Sokratis A.; Huang, Alexander C.; Mathew, Divij; Kuthuru, Oliva; Goodwin, Eileen C.; Weirick, Madison E.; Bolton, Marcus J.; Arevalo, Claudia P.; Ramos, Andre; Jasen, CJ; Conrey, Peyton E; Sayed, Samir; Giannini, Heather M.; D’Andrea, Kurt; Meyer, Nuala J.; Behrens, Edward M.; Bassiri, Hamid; Hensley, Scott E.; Henrickson, Sarah E.; Teachey, David T.; Betts, Michael R.; Wherry, E. John
Title: Deep immune profiling of MIS-C demonstrates marked but transient immune activation compared to adult and pediatric COVID-19 Cord-id: hvxmtb8y Document date: 2021_3_2
ID: hvxmtb8y
Snippet: Pediatric COVID-19 following SARS-CoV-2 infection is associated with fewer hospitalizations and often milder disease than in adults. A subset of children, however, present with Multisystem Inflammatory Syndrome in Children (MIS-C) that can lead to vascular complications and shock, but rarely death. The immune features of MIS-C compared to pediatric COVID-19 or adult disease remain poorly understood. We analyzed peripheral blood immune responses in hospitalized SARS-CoV-2 infected pediatric patie
Document: Pediatric COVID-19 following SARS-CoV-2 infection is associated with fewer hospitalizations and often milder disease than in adults. A subset of children, however, present with Multisystem Inflammatory Syndrome in Children (MIS-C) that can lead to vascular complications and shock, but rarely death. The immune features of MIS-C compared to pediatric COVID-19 or adult disease remain poorly understood. We analyzed peripheral blood immune responses in hospitalized SARS-CoV-2 infected pediatric patients (pediatric COVID-19) and patients with MIS-C. MIS-C patients had patterns of T cell-biased lymphopenia and T cell activation similar to severely ill adults, and all patients with MIS-C had SARS-CoV-2 spike-specific antibodies at admission. A distinct feature of MIS-C patients was robust activation of vascular patrolling CX3CR1+ CD8+ T cells that correlated with the use of vasoactive medication. Finally, whereas pediatric COVID-19 patients with acute respiratory distress syndrome (ARDS) had sustained immune activation, MIS-C patients displayed clinical improvement over time, concomitant with decreasing immune activation. Thus, non-MIS-C versus MIS-C SARS-CoV-2 associated illnesses are characterized by divergent immune signatures that are temporally distinct from one another and implicate CD8+ T cells in the clinical presentation and trajectory of MIS-C.
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