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The Immunology of Multisystem Inflammatory Syndromein Children with COVID-19

Camila Rosat Consiglio, Nicola Cotugno, Fabian Sardh, Christian Pou, Donato Amodio, Lucie Rodriguez, Ziyang Tan, Sonia Zicari, Alessandra Ruggiero, Giuseppe Rubens Pascucci, Veronica Santilli, Tessa Campbell, Yenan Bryceson, Daniel Eriksson, Jun Wang, Alessandra Marchesi, Tadepally Lakshmikanth, Andrea Campana, Alberto Villani, Paolo Rossi, the CACTUS study team, Nils Landegren, Paolo Palma, Petter Brodin
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Resumen

SARS-CoV-2 infection is typically very mild and often asymptomatic in children. A complication is the rare Multisystem Inflammatory Syndrome in Children (MIS-C) associated with COVID-19, presenting 4-6 weeks after infection as high fever, organ dysfunction and strongly elevated markers of inflammation. The pathogenesis is unclear but has overlapping features with Kawasaki disease suggestive of vasculitis and a likely autoimmune etiology. We apply systems-level analyses of blood immune cells, cytokines and autoantibodies in healthy children, children with Kawasaki disease enrolled prior to COVID-19, children infected with SARS-CoV-2 and children presenting with MIS-C. We find that the inflammatory response in MIS-C differs from the cytokine storm of severe acute COVID-19, shares several features with Kawasaki disease, but also differs from this condition with respect to T-cell subsets, IL-17A and biomarkers associated with arterial damage. Finally, autoantibody profiling suggests multiple autoantibodies that could be involved in the pathogenesis of MIS-C. 

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Publicado en el sitio 2020-09-07 17:35:09

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