scholarly journals Post-COVID-19 Outbreak of Severe Kawasaki-like Multisystem Inflammatory Syndrome in Children

2021 ◽  
Vol 28 (1) ◽  
pp. 109-116
Author(s):  
Sadia Shakeel ◽  
Mohamed Azmi Ahmad Hassali
Keyword(s):  
Immune Response ◽  
Disease Management ◽  
Blood Vessels ◽  
Clinical Manifestations ◽  
The Body ◽  
Cardiac Complications ◽  
Novel Coronavirus ◽  
Inflammatory Syndrome ◽  
Second Wave ◽  
Different Parts

With the continuation of the second wave of a novel coronavirus disease (COVID-19), which is likely to be even more devastating, there are several associated health problems. COVID-19 is usually mild and non-fatal in children. However, in rare cases, children could severely be affected, and clinical manifestations may differ from adults. A multisystem inflammatory syndrome in children (MIS-C) is a rare but serious complication associated with COVID-19, initiated by an overactive immune response in kids that usually hits weeks after exposure to the COVID-19. MIS-C is a disorder in which inflammation could occur in different parts of the body. The disease puts pressure on the heart, as blood vessels leading towards the heart get inflamed and incapable of carrying adequate blood, hence producing cardiac complications in children hospitalised with MIS-C. The problem seems to be associated with COVID-19 in children; however, the association between MIS-C and COVID-19 is still unidentified. There is very little understanding of what triggers the MIS-C, which necessitates a rigorous mapping of the disease and associated risk elements for better disease management and navigating through this crisis.

scholarly journals Plasmacytoid Dendritic Cells Depletion and Elevation of IFN-γ Dependent Chemokines CXCL9 and CXCL10 in Children With Multisystem Inflammatory Syndrome

2021 ◽  
Vol 12 ◽  
Author(s):  
Francesca Caldarale ◽  
Mauro Giacomelli ◽  
Emirena Garrafa ◽  
Nicola Tamassia ◽  
Alessia Morreale ◽  
...  
Keyword(s):  
Immune Response ◽  
Dendritic Cells ◽  
Clinical Manifestations ◽  
Plasmacytoid Dendritic Cells ◽  
Type I ◽  
Reactive Protein ◽  
Cardiovascular Damage ◽  
Inflammatory Chemokines ◽  
Ifn Γ ◽  
Inflammatory Syndrome

BackgroundSARS-CoV-2 occurs in the majority of children as COVID-19, without symptoms or with a paucisymptomatic respiratory syndrome, but a small proportion of children develop the systemic Multi Inflammatory Syndrome (MIS-C), characterized by persistent fever and systemic hyperinflammation, with some clinical features resembling Kawasaki Disease (KD).ObjectiveWith this study we aimed to shed new light on the pathogenesis of these two SARS-CoV-2-related clinical manifestations.MethodsWe investigated lymphocyte and dendritic cells subsets, chemokine/cytokine profiles and evaluated the neutrophil activity mediators, myeloperoxidase (MPO), and reactive oxygen species (ROS), in 10 children with COVID-19 and 9 with MIS-C at the time of hospital admission.ResultsPatients with MIS-C showed higher plasma levels of C reactive protein (CRP), MPO, IL-6, and of the pro-inflammatory chemokines CXCL8 and CCL2 than COVID-19 children. In addition, they displayed higher levels of the chemokines CXCL9 and CXCL10, mainly induced by IFN-γ. By contrast, we detected IFN-α in plasma of children with COVID-19, but not in patients with MIS-C. This observation was consistent with the increase of ISG15 and IFIT1 mRNAs in cells of COVID-19 patients, while ISG15 and IFIT1 mRNA were detected in MIS-C at levels comparable to healthy controls. Moreover, quantification of the number of plasmacytoid dendritic cells (pDCs), which constitute the main source of IFN-α, showed profound depletion of this subset in MIS-C, but not in COVID-19.ConclusionsOur results show a pattern of immune response which is suggestive of type I interferon activation in COVID-19 children, probably related to a recent interaction with the virus, while in MIS-C the immune response is characterized by elevation of the inflammatory cytokines/chemokines IL-6, CCL2, and CXCL8 and of the chemokines CXCL9 and CXL10, which are markers of an active Th1 type immune response. We believe that these immunological events, together with neutrophil activation, might be crucial in inducing the multisystem and cardiovascular damage observed in MIS-C.

scholarly journals COVID-19 Associated Multisystem Inflammatory Syndrome: A Systematic Review and Meta-analysis

2020 ◽  
Author(s):  
Ashkan Baradaran ◽  
Abdolreza Malek ◽  
Nasrin Moazzen ◽  
Zahra Abbasi Shaye
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Gastrointestinal Symptoms ◽  
Multiple Organ ◽  
Current Evidence ◽  
Cardiac Complications ◽  
Clinical Presentations ◽  
Atypical Kawasaki Disease ◽  
Novel Coronavirus ◽  
Inflammatory Syndrome

The prevalence of multisystem inflammatory syndrome in children (MIS-C) has increased since the coronavirus disease 2019 (COVID-19) pandemic started. This study was aimed to describe clinical manifestation and outcomes of MIS-C associated with COVID-19. This systematic review and meta-analysis were conducted on all available literature until July 3rd, 2020. The screening was done by using the following keywords: (“novel coronavirus” Or COVID-19 or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or coronavirus) and ("MIS-C" or "multisystem inflammatory" or Kawasaki). Data on gender, ethnicity, clinical presentations, need for mechanical ventilation or admission to intensive care unit (ICU), imaging, cardiac complications, and COVID-19 laboratory results were extracted to measure the pooled estimates. Out of 314 found articles, 16 articles with a total of 600 patients were included in the study, the most common presentation was fever (97%), followed by gastrointestinal symptoms (80%), and skin rashes (60%) as well as shock (55%), conjunctivitis (54%), and respiratory symptoms (39%). Less common presentations were neurologic problems (33%), and skin desquamation (30%), MIS-C was slightly more prevalent in males (53.7%) compared to females (46.3%). The findings of this meta-analysis on current evidence found that the common clinical presentations of COVID-19 associated MIS-C include a combination of fever and mucocutaneous involvements, similar to atypical Kawasaki disease, and multiple organ dysfunction. Due to the relatively higher morbidity and mortality rate, it is very important to diagnose this condition promptly.  

scholarly journals SARS-CoV-2 infection and the antiviral innate immune response

2020 ◽  
Author(s):  
Hui Yang ◽  
Yingying Lyu ◽  
Fajian Hou
Keyword(s):  
Immune Response ◽  
Innate Immune Response ◽  
Clinical Manifestations ◽  
Innate Immune ◽  
World Health ◽  
The Novel ◽  
Global Public Health ◽  
Replication Process ◽  
Novel Coronavirus ◽  
Health Organization

Abstract The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak began in December 2019, causing the illness known as the novel coronavirus disease 2019 (COVID-19). The virus spread rapidly worldwide to become a global public health emergency. As of 15 November 2020, more than 53 million confirmed cases and over one million deaths worldwide have been reported (World Health Organization, 2020). The SARS-CoV-2 genome was sequenced and studies are ongoing to further understand the epidemiology, clinical manifestations, etiological structure, cellular receptor angiotensin II converting enzyme (ACE2), and intracellular replication process of the virus. Currently, thousands of clinical trials related to SARS-CoV-2 are underway (https://clinicaltrials.gov/). However, no vaccines or drugs have yet been approved, until very recently, for direct treatment or prevention of COVID-19 and only supportive treatment has been applied clinically. This review will discuss the possible mechanism of the innate immune response to SARS-CoV-2 infection and provide insight into the development of related therapeutics.

scholarly journals Case Report: MIS-C Temporarily Associated With COVID-19 Complicated by Reye's Syndrome

2021 ◽  
Vol 9 ◽  
Author(s):  
Fabrício Silva Pessoa ◽  
Eliza Maria da Costa Brito Lacerda ◽  
Valdênia Costa Gonçalves ◽  
Barbara Neiva Tanaka
Keyword(s):  
Case Report ◽  
Acetylsalicylic Acid ◽  
Clinical Manifestations ◽  
Coronary Aneurysm ◽  
Human Immunoglobulin ◽  
The Novel ◽  
Reye's Syndrome ◽  
Serious Illness ◽  
Novel Coronavirus ◽  
Inflammatory Syndrome

We describe a 7-year-old child with multisystemic inflammatory syndrome that was temporarily associated with the novel coronavirus disease which evolved into serious illness, with coronary aneurysm, using human immunoglobulin and acetylsalicylic acid, in which clinical manifestations including hepatitis, convulsions, and coma were aggravated with Reye's syndrome. To date, there has been no report of the association of multisystemic inflammatory syndrome that is temporarily associated with the novel coronavirus disease and Reye's syndrome.

scholarly journals A case report on COVID-19 associated multisystem inflammatory syndrome in children

2021 ◽  
Vol 8 (9) ◽  
pp. 1622
Author(s):  
Sachin Kumar ◽  
Deepak Sharma ◽  
Khushboo Tongaria ◽  
Naman Bansal
Keyword(s):  
Similar Case ◽  
High Titre ◽  
Igg Antibodies ◽  
Inflammatory Conditions ◽  
Intravenous Antibiotics ◽  
High Incidence ◽  
Inflammatory Syndrome ◽  
Second Wave ◽  
Different Parts ◽  
D Dimer

As severe acute respiratory syndrome coronavirus 2 continues to spread worldwide, there have been increasing reports from different parts of India during second wave of infection describing children and adolescents with COVID-19-associated multisystem inflammatory conditions. We describe clinical features and management in children with multisystem inflammatory syndrome children (MIS-C) from the Delhi metropolitan area, which had a high incidence of coronavirus disease 2019 (COVID-19). We report a similar case presenting with persisting fever, rashes, bulbar conjunctivitis, abdominal pain, decreased urine output and shock. Initial reports suggestive of high inflammatory markers, neutrophilic leukocytosis, high D-dimer and found to have COVID-19 IgG antibodies positive in high titre. Managed successfully in PICU with bolos fluids, intravenous antibiotics, steroids and anticoagulation. 

scholarly journals Mathematical Modeling of Cytotoxic Lymphocyte-Mediated Immune Response to Hepatitis B Virus Infection

2008 ◽  
Vol 2008 ◽  
pp. 1-9 ◽  
Author(s):  
Changjiang Long ◽  
Huan Qi ◽  
Sheng-Hu Huang
Keyword(s):  
Immune Response ◽  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Cell Damage ◽  
Clinical Manifestations ◽  
Complete Recovery ◽  
The Body ◽  
Hbv Infection ◽  
Cytotoxic Lymphocyte ◽  
B Virus

Nowak's model of the human immunodeficiency virus (HIV) infection has been extensively and successfully used to simulate the interaction between HIV and cytotoxic lymphocyte- (CTL-) mediated immune response. However, this model is not available for hepatitis B virus (HBV) infection. As the enhanced recruitment of virus-specific CTLs into the liver has been an important novel concept in the pathogenesis of hepatitis B, we develop a specific mathematical model analyzing the relationship between HBV and the CTL-mediated immune response, and the indicator of the liver cell damage, alanine aminotransferase (ALT). The stability condition of the complete recovery equilibrium point at which HBV will be eliminated entirely from the body is discussed. A different set of parameters is used in the simulation, and the results show that the model can interpret the wide variety of clinical manifestations of HBV infection. The model suggests that a rapid and vigorous CTL response is required for resolution of HBV infection.

Down But Not Out—Circulatory Arrest Pressures

2011 ◽  
pp. 70-76
Author(s):  
James R. Munis
Keyword(s):  
Blood Pressure ◽  
Cardiac Arrest ◽  
Blood Vessels ◽  
Blood Volume ◽  
Circulatory Arrest ◽  
Circulatory System ◽  
The Body ◽  
Blood Pressures ◽  
System Volume ◽  
Different Parts

Suppose that your heart has just stopped. What would happen to your blood pressure? At least 2 things would happen that you might not predict (and I hope you won't discover them anytime soon). First, the various blood pressures in the different parts of your circulatory system would converge to the same value. Second, you might be surprised to find that your blood pressure is not zero. That's not just because of vertical (hydrostatic) gradients within the body. Because the blood volume is considerably greater than the passive circulatory system volume, the blood vessels are slightly stretched and maintain a non-zero pressure even after the heart stops. To determine the actual non-zero pressure during cardiac arrest, we only have to divide the stressed blood volume by vascular compliance.

scholarly journals Varying Presentations of Multisystem Inflammatory Syndrome Temporarily Associated with COVID-19

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Jasmina Krikilion ◽  
Lisa Nuyttens ◽  
Siel Daelemans ◽  
Karlien François ◽  
Reiner Mauel ◽  
...  
Keyword(s):  
Distress Syndrome ◽  
Early Recognition ◽  
Clinical Manifestations ◽  
Toxic Shock ◽  
Clinical Presentations ◽  
Atypical Kawasaki Disease ◽  
Case Presentations ◽  
Novel Coronavirus ◽  
Inflammatory Syndrome ◽  
Beneficial Outcome

Background. A novel coronavirus identified in 2019 leads to a pandemic of severe acute respiratory distress syndrome with important morbidity and mortality. Initially, children seemed minimally affected, but there were reports of cases similar to (atypical) Kawasaki disease or toxic shock syndrome, and evidence emerges about a complication named paediatric inflammatory multisystem syndrome temporarily associated with SARS-CoV-2 (PIMS-TS) or multisystem inflammatory syndrome in children (MIS-C). Case Presentations. Two cases were compared and discussed demonstrating varying presentations, management, and evolution of MIS-C. These cases are presented to increase awareness and familiarity among paediatricians and emergency physicians with the different clinical manifestations of this syndrome. Discussion. MIS-C may occur with possible diverse clinical presentations. Early recognition and treatment are paramount for a beneficial outcome.

scholarly journals Antibody responses to SARS-CoV2 are distinct in children with MIS-C compared to adults with COVID-19

2020 ◽  
Author(s):  
Stuart P Weisberg ◽  
Thomas Connors ◽  
Yun Zhu ◽  
Matthew Baldwin ◽  
Wen-Hsuan Lin ◽  
...  
Keyword(s):  
Distress Syndrome ◽  
Severe Disease ◽  
Clinical Manifestations ◽  
Serological Response ◽  
The Novel ◽  
N Protein ◽  
Mild Disease ◽  
Patient Groups ◽  
Novel Coronavirus ◽  
Inflammatory Syndrome

Clinical manifestations of COVID-19 caused by the novel coronavirus SARS-CoV-2 are associated with age. While children are largely spared from severe respiratory disease, they can present with a SARS-CoV-2-associated multisystem inflammatory syndrome (MIS-C) similar to Kawasaki's disease. Here, we show distinct antibody (Ab) responses in children with MIS-C compared to adults with severe COVID-19 causing acute respiratory distress syndrome (ARDS), and those who recovered from mild disease. There was a reduced breadth and specificity of anti-SARS-CoV-2-specific antibodies in MIS-C patients compared to the COVID patient groups; MIS-C predominantly generated IgG Abs specific for the Spike (S) protein but not for the nucleocapsid (N) protein, while both COVID-19 cohorts had anti-S IgG, IgM and IgA Abs, as well as anti-N IgG Abs. Moreover, MIS-C patients had reduced neutralizing activity compared to COVID-19 cohorts, indicating a reduced protective serological response. These results suggest a distinct infection course and immune response in children and adults who develop severe disease, with implications for optimizing treatments based on symptom and age.

scholarly journals Immune Response towards COVID-19

2021 ◽  
Vol 2 (12) ◽  
pp. 1197-1201
Author(s):  
Muhammad Akram ◽  
Waqas Ahmed ◽  
Abolfazl Jafari-Sales ◽  
Nilgun Kusculu ◽  
Mounir M Bekhit ◽  
...  
Keyword(s):  
Immune Response ◽  
The Body ◽  
Elastic Response ◽  
Lung Cells ◽  
Angiotensin Converting Enzyme 2 ◽  
Non Invasive ◽  
Natural Response ◽  
Novel Coronavirus ◽  
Viral Components ◽  
Source Retrieval

Background: As the world witnessed the outbreak of coronavirus illness 2019 (COVID-19), a disorder developed as a result of a novel coronavirus, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), increasing genetics with healthcare evidence suggest a corresponding leadership to SARS as well as the Middle East Respiratory Syndrome (MERS). Aim: The aim of this review is to highlight Immune response of human body toward COVID-19. Materials and methods: This was a narrative review. A comprehensive literature search was done using PubMed, Google Scholar, Scopus, and EMBASE using the keywords, Immune Response; COVID-19; Vaccination; SARS-Cov-2; ACE2; Coronavirus; MERS. Results: A flow of viral components passes to the body by means of nostrils, mouth and eyes. SARS-CoV-2 is in a position to continue to become unnoticed extended than numerous influenza or coronaviruses. Its proteins can accomplish entry by unlocking the Angiotensin-Converting Enzyme 2 (ACE2) protein in the lung cells; viruses also possess antigens furthermore recognize that these are what cries the immunity into movement via making antibodies. Investigators demonstrate an extensive variety of immune cells respond to COVID-19 along with valuable source retrieval, discovering that might want to notify the manufacturing of a viable vaccination. Conclusion: The body's natural response to a viral infection is a non-invasive intrinsic response in which macrophages, neutrophils, and dendritic cells limit the virus's progression and may even prevent it by multiplying symptoms. This non-invasive solution is accompanied by an elastic response in which the body produces radicals that primarily adjust to the herpes virus.

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