Immune profile of children diagnosed with multisystem inflammatory syndrome associated with SARS-CoV-2 infection (MIS-C)

Ewelina Gowin; Grzegorz Dworacki; Bartosz Siewert; Jacek Wysocki; Danuta Januszkiewicz-Lewandowska

doi:10.5114/ceji.2022.116385

eISSN: 1644-4124
ISSN: 1426-3912

Central European Journal of Immunology

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2/2022
vol. 47

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abstract:

Clinical immunology

Immune profile of children diagnosed with multisystem inflammatory syndrome associated with SARS-CoV-2 infection (MIS-C)

Ewelina Gowin

¹

,

Grzegorz Dworacki

²

,

Bartosz Siewert

¹

,

Jacek Wysocki

¹

,

Danuta Januszkiewicz-Lewandowska

³

Health Promotion Department, Poznan University of Medical Sciences, Poland
Department of Clinical Pathomorphology, Poznan University of Medical Sciences, Poland
Department of Oncology, Hematology, and Bone Marrow Transplantation, Poznan University of Medical Sciences, Poland

Cent Eur J Immunol 2022; 47 (2): 151-159

DOI: https://doi.org/10.5114/ceji.2022.116385

Online publish date: 2022/05/30

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Introduction
The pathophysiology of multisystem inflammatory syndrome associated with SARS-CoV-2 infection (MIS-C) remains poorly understood. This study aimed to define peripheral blood immune features in patients with MIS-C.

Material and methods
We analyzed seven children diagnosed with MIS-C between April 1 and May 15, 2021, in St. Joseph’s Children’s Hospital in Poznan (Poland).

Results
All patients had elevated inflammatory markers, IgG antibodies against SARS-CoV-2, and lymphopenia with a marked decrease in CD4+ and CD8+ T cells. The majority of CD4+ T cells were naive cells. Almost all (6/7) of the analyzed patients had a higher CD4+/CD8+ T cell ratio than average values. B cells were within the normal range – the majority were non-memory cells.

Conclusions
Children with MIS-C do not resemble adults during COVID-19 recovery. The immune profile of the studied patients differs from that of children with Kawasaki disease (KD), but it is similar to that of adults with severe COVID-19. The proposed explanation is a profound lymphopenia caused by SARS-CoV-2 infection – which persists for weeks – as a result leading to uncontrolled inflammation. In COVID-19 patients the T cell level returns to normal after the second week of the disease. Our data suggest that in children prolonged lymphopenia after COVID-19 can be a practical marker for possible MIS-C alert. If there is a continuum from lymphopenia to MIS-C, there is room for screening and prevention. Further studies are needed to determine whether steroid treatment introduced in a child with prolonged lymphopenia could stop the inflammatory process.

keywords:

Immune profile of children diagnosed with multisystem inflammatory syndrome associated with SARS-CoV-2 infection (MIS-C)

Ewelina Gowin 1 , Grzegorz Dworacki 2 , Bartosz Siewert 1 , Jacek Wysocki 1 , Danuta Januszkiewicz-Lewandowska 3

MIS-C, Kawasaki disease, T cells, adaptive immunity, inflammation

Ewelina Gowin

¹

,

Grzegorz Dworacki

²

,

Bartosz Siewert

¹

,

Jacek Wysocki

¹

,

Danuta Januszkiewicz-Lewandowska

³