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Background Paediatric inflammatory multisystem syndrome (PIMS) associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been described since mid-April 2020 with the first reports coming from Europe. Our objective was to describe the characteristics of patients among the Brazilian population. Methods A multicenter retrospective study was conducted with the participation of five pediatric rheumatology centers in Brazil during the period from March to November 2020. Children and adolescents with PIMS temporally associated with SARS-CoV-2 (TS) who met the definition criteria for the disease according to the Royal College of Paediatrics and Child Health were included. Demographic, clinical, laboratory, therapeutic characteristics and molecular and serological diagnosis of SARS-CoV-2 infection were described. Results Fifty-seven children and adolescents with PIMS-TS were evaluated, 54% female, with a median age of 8 (3–11) years. Most (86%) were previously healthy, with asthma being the main comorbidity, present in 10% of the patients. Fever was the main manifestation, present in all patients, followed by mucocutaneous and gastrointestinal features, present in 89% and 81% of the patients, respectively. Myocarditis occurred in 21% of the patients and in 68% of them required intensive care. The Kawasaki disease phenotype occurred in most patients (77%). All patients had elevated inflammatory markers, with elevated CRP being the most found (98%). Anemia and lymphopenia were present in 79% and 72%, respectively. Laboratory evidence of SARS-CoV-2 was found in 77% of the patients, with 39% positive RT-PCR and 84% positive serology for SARS-CoV-2. An immunomodulatory treatment was performed in 91% of the patients, with 67% receiving intravenous immunoglobulin (IVIG) associated with glucocorticoid, 21% receiving IVIG, and 3.5% receiving glucocorticoid. The median length of hospitalization was 10 days. Conclusions This study showed a high morbidity of PIMS-TS in Brazilian children, with a prolonged length of hospitalization and a high rate of admission to pediatric intensive care unit. Multicenter prospective studies are needed to assess the morbidity of the disease in the medium and long term.

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RATIONALE: Atopic dermatitis (AD) is a chronic inflammatory skin disorder characterized by type-2 inflammation, and Staphylococcus aureus colonization. Ectopic olfactory receptors (OR) can be found in non-olfactory tissues, but their role in these tissues is not understood. METHODS: OR expression was examined by low input whole transcriptome sequencing of skin tape strips and biopsies collected from AD patients and healthy controls (NC). OR10G7 mRNA expression was analyzed by RT-PCR in AD and NC biopsies and primary human keratinocytes. OR10G7 expression in AD and NC skin samples was evaluated by fluorescent immunostaining. RESULTS: 381 OR gene transcripts were found in the skin samples, with the greatest OR expression detected in the skin tape strips, corresponding to the upper granular layer of the skin. The gene ontology groups of ''OR activity'' and ''chemical stimulus involved in sensory perception'' were found to be down-regulated in AD as compared to NC skin. However, individual OR transcripts were significantly induced or inhibited in AD skin colonized by S. aureus. As shown by RT-PCR, OR10G7 mRNA expression was significantly (p<0.05) increased in AD as compared to NC whole biopsies. OR10G7 mRNA expression was detected in primary human keratinocytes. OR10G7 protein expression was found in the skin granular layer and was significantly upregulated in nonlesional AD as compared to NC skin (MFI, Mean+SE, 292645 vs. 161637, p<0.05). CONCLUSIONS: This study demonstrates previously unrecognized OR expression in the skin and their modulation in AD, suggesting potential contribution of these receptors in sensing bacterial colonization and wound healing responses.