Biomarkers Found for COVID-19 Condition in Children May Help Predict Disease Severity and Develop MIS-C Therapies

This rare but serious inflammatory condition that affects children who contract COVID-19 produces a distinctive pattern of biomarkers that may help physicians predict disease severity and also aid researchers in developing new treatments, according to findings of the study.

The Cedars-Sinai study focused on MIS-C, an inflammatory response involving multiple organs that can occur weeks after infection with SARS-CoV-2, the virus that causes COVID-19. The investigators examined a small group of patients to identify an array of pathogenic pathways culminating in MIS-C, along with proteins in the blood with potential to act as biomarkers to forecast the severity of the syndrome and help drive treatment decisions. A picture is emerging of MIS-C as an autoimmune disease in which the immune system becomes overactive and mistakenly attacks the body's own organs, according to the researchers. This process may be triggered by widespread tissue damage caused by the SARS-CoV-2 infection.

Children with MIS-C often present symptoms similar to those observed in the so-called cytokine storm, an inflammatory response that can be fatal in COVID-19 patients. These symptoms may include persistent fever and gastrointestinal, respiratory, neurological and cardiovascular problems, such as shock and heart muscle inflammation. Previous research had uncovered similar biological processes involved in MIS-C, the cytokine storm and toxic shock syndrome - a rare, life-threatening complication of bacterial infections. For the new study, the research team adopted an interdisciplinary approach in which they examined 69 children, including those with and without MIS-C and seven with another pediatric inflammatory disorder - Kawasaki disease. Future investigations are needed to validate the findings in a larger patient group, according to the researchers.

"We deployed an array of advanced techniques, including proteomics, RNA sequencing and analyses of antibodies and immune system signaling," said Jennifer Van Eyk, PhD, director of the Advanced Clinical Biosystems Research Institute in the Smidt Heart Institute at Cedars-Sinai, and an expert on proteomics - the study of proteins at the molecular and genetic levels. "By combining forces, we are better able to accelerate scientific discoveries to keep pace with the rapidly evolving pandemic and to inform clinical decisions."

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