Multi-inflammatory Syndrome in Children Related to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in Spain

Moraleda, Cinta; Serna-Pascual, Miquel; Soriano‐Arandes, Antoni; Simó, Sergi; Epalza, Cristina; Santos, Mar; Grasa, Carlos; Rodriguez, María José Antona; Soto, Beatriz; Gallego, Nerea; Ruíz, Yolanda; Urretavizcaya-Martinez, María; Pareja, Marta; Sanz-Santaeufemia, Francisco José; Fumadó, Victòria; Lanaspa, Miguel; Jordán, Iolanda; Prieto, Luís; Belda, Sylvia; Toral-Vázquez, Belén; Rincón, Elena; Gil-Villanueva, Nuria; Méndez-Echevarría, Ana; Castillo-Serrano, Ana; Rivière, Jacques G.; Soler‐Palacín, Pere; Rojo, Pablo; Tagarro, Alfredo; Valle, Rut Del; Barrios, Ana; Villanueva, Sara; Contreras, Jesús Ruíz; Calvo, Cristina; Molino, Paula Rodríguez; Mellado, María José; Ceano, María de; Penin, María; Villaverde, Serena; Pérez, María José de Dios; Otheo, Enrique; Falcón, María Dolores; Neth, Olaf; Olbrich, Peter; Goycoechea, Walter; Martín, Laura; Iglesias, María; Cadenas, José Antonio Alonso; Herrero, Blanca; Cobo, Elvira; Tovizi, Mariam; Galán, Pilar; Guillén, Sara; Navas, Adriana; García-García, Maria Luz; Llorente, Marta; Perez, S. G.; Figueroa, L González; Bermejo, Amanda; Mendoza, Pablo; Sabrido, Gema; Hernández, María José; Jiménez, Ana Belén; Berzosa, Arantxa; Illán, Marta; Bernardino, Maria de Lourdes Amaral; Jensen, Julia; Vidal, Paula; Domínguez, Sara; Gutiérrez, Lourdes; Ocaña, Angustias; Belinchón, Isabel; Guzmán, María Fernanda; Pascual, María-Jesús; Machín, Ana López; Ruiz, Beatriz Arteta; Menasalvas, Ana; Méndez, María José; Hurtado, Ángela María Rincón; Ara, Fátima; Cabañas, Fernando; Oltra, Manuel; Villarroya, Álvaro; Sánchez-Códez, María Isabel; Montesinos, Elena; Aguirre, Mercedes; Rius, Neus; Gómez, Alba; Bretón, Rafael; Rodríguez-Benjumea, Margarita; Campos, Ana Sara Martins de; Reymundo, M. García

doi:10.1093/cid/ciaa1042

Cited by 113 publications

(145 citation statements)

References 1 publication

Supporting

Mentioning

125

Contrasting

Unclassified

Order By: Relevance

“…While the induction of effective cellular immunity is likely essential for the COVID-19 control, dysregulated T cell activation (by overproduction of IFN associated cytokines promoting retention of lymphocytes in lymphoid organs) may underly main immunopathology and contribute to disease severity in COVID-19 patients [32,[34][35][36]. Although the exposure to pathogens may be lower in PID patients due to more strict self-isolation, it should be noted that the majority of PID cases require to visit the hospital and medical centers regularly which may predispose them even more to exposure to different pathogens as well as COVID-19.…”

Section: Discussionmentioning

confidence: 99%

Impact of SARS-CoV-2 Pandemic on Patients with Primary Immunodeficiency

et al. 2020

View full text Add to dashboard Cite

Although it is estimated that COVID-19 life-threatening conditions may be diagnosed in less than 1:1000 infected individuals below the age of 50, but the real impact of this pandemic on pediatric patients with different types of primary immunodeficiency (PID) is not elucidated. The current prospective study on a national registry of PID patients showed that with only 1.23 folds higher incidence of infections, these patients present a 10-folds higher mortality rate compared to population mainly in patients with combined immunodeficiency and immune dysregulation. Therefore, further management modalities against COVID-19 should be considered to improve the survival rate in these two PID entities using hematopoietic stem cell transplantation and immunomodulatory agents.

show abstract

Section: Discussionmentioning

confidence: 99%

Impact of SARS-CoV-2 Pandemic on Patients with Primary Immunodeficiency

et al. 2020

View full text Add to dashboard Cite

show abstract

“…We have reported four patients, along with the review of 320 pediatric patients from the systematic literature search (Table 1) [6,[12][13][14][15][16][17]. In addition to these articles presented in the table, six articles reported Kawasaki-like disease in children with COVID-19 [36,[48][49][50][51][52]. These articles were not included since there were no details about the reported patients.…”

Section: Discussionmentioning

confidence: 99%

Kawasaki-like disease in children with COVID-19

et al. 2020

View full text Add to dashboard Cite

Children with Coronavirus disease 2019 (COVID-19) are being reported to have manifestations of hyperinflammatory states and/or Kawasaki-like disease. In this study, we investigated children with typical and atypical Kawasaki disease (KD) likely to be associated with COVID-19. We have reported four children with Kawasaki-like disease probably associated with COVID-19. The clinical features were consistent with incomplete KD in three patients. SARS-CoV-2 RT-PCR was positive in one and the serology was positive in one patient with negative RT-PCR. Corticosteroids, anakinra, intravenous immunoglobulin (IVIG), and acetylsalicylic acid were used in the treatment. Three patients recovered after the treatment while one patient died. The literature review revealed 36 articles describing 320 children with Kawasaki-like disease associated with COVID-19. SARS-CoV-2 RT-PCR was negative in 120 (65.5%) of 183 patients while the serology was positive in 130 (83.8%) of 155 patients. The therapeutic options have included IVIG, acetylsalicylic acid, tocilizumab, anakinra, enoxaparin, and methylprednisolone. Pediatric COVID-19 cases may present with atypical/incomplete Kawasaki-like disease. Thus, pediatricians need to be aware of such atypical presentations resembling KD for early diagnosis of COVID-19.

show abstract

“…Reports of children presenting with a more serious Kawasaki disease/toxic shock-like illness ('Paediatric Inflammatory Multisystem Syndrome Temporally associated with SARS-CoV-2 [PIMS-TS]' in Europe; also known as Multisystem Inflammatory Syndrome in Children [MIS-C] in the USA) might seem to also support the concept that vascular function plays an important role in the pathogenesis of COVID-19. [39][40][41][42][43][44][45][46][47] However, the pathogenesis of PIMS-TS, which usually presents 4-6 weeks after infection, differs from acute COVID-19, as it is likely to be an autoimmune phenomenon. 48 In addition, the hyperinflammation underlying PIMS-TS is different to that observed in adults with severe COVID-19, which includes higher levels of IL-7 and IL-8 and lower levels of effector CD4 + T cells.…”

Section: Factors Leading To Adults Being At Higher Risk Differences Imentioning

confidence: 99%

Why is COVID-19 less severe in children? A review of the proposed mechanisms underlying the age-related difference in severity of SARS-CoV-2 infections

2020

View full text Add to dashboard Cite

In contrast to other respiratory viruses, children have less severe symptoms when infected with the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In this review, we discuss proposed hypotheses for the age-related difference in severity of coronavirus disease 2019 (COVID-19).Factors proposed to explain the difference in severity of COVID-19 in children and adults include those that put adults at higher risk and those that protect children. The former include: (1) age-related increase in endothelial damage and changes in clotting function; (2) higher density, increased affinity and different distribution of angiotensin converting enzyme 2 receptors and transmembrane serine protease 2; (3) pre-existing coronavirus antibodies (including antibody-dependent enhancement) and T cells; (4) immunosenescence and inflammaging, including the effects of chronic cytomegalovirus infection; (5) a higher prevalence of comorbidities associated with severe COVID-19 and (6) lower levels of vitamin D. Factors that might protect children include: (1) differences in innate and adaptive immunity; (2) more frequent recurrent and concurrent infections; (3) pre-existing immunity to coronaviruses; (4) differences in microbiota; (5) higher levels of melatonin; (6) protective off-target effects of live vaccines and (7) lower intensity of exposure to SARS-CoV-2.

show abstract

Multi-inflammatory Syndrome in Children Related to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in Spain

Cited by 113 publications

References 1 publication

Impact of SARS-CoV-2 Pandemic on Patients with Primary Immunodeficiency

Impact of SARS-CoV-2 Pandemic on Patients with Primary Immunodeficiency

Kawasaki-like disease in children with COVID-19

Why is COVID-19 less severe in children? A review of the proposed mechanisms underlying the age-related difference in severity of SARS-CoV-2 infections

Contact Info

Product

Resources

About