Pediatric multisystem inflammatory syndrome has a major impact on more black and Latino children

Pediatric multisystem inflammatory syndrome (MIS-C) is more black and Latin than white children, according to a new observational study of 124 pediatric patients treated at the National Children’s Hospital in Washington, DC. Black children were at highest risk.

Researchers also found that cardiac complications such as systolic myocardial dysfunction and regurgitation are more common in patients with severe MIS-C. Of the 124 patients, 63 were eventually diagnosed with MIS-C and had similar symptoms, but were eventually compared to 61 patients who were considered to be controls with another diagnosis. It was.

Published in the study Pediatric journal, Researchers provide insights into key functions that distinguish MIS-C patients, provide more realistic images of disease burden in the pediatric population, for early detection of disease and optimal results. Supports treatment. COVID-related syndromes have affected nearly 4,000 children in the United States over the past year.

Early reports showed serious MIS-C-related illnesses, significant changes in treatment, and mortality. However, this study showed that early recognition and standardized treatment could almost eliminate short-term mortality.

Such data are important for the development of clinical trials on the long-term effects of MIS-C.Our study shows the demographic, clinical, biomarker characteristics of this disease, and Viral load And virus sequencing. “

Dr. Roberta Deviasi, MD, Principal Writer and Chief Researcher, Department of Pediatric Infectious Diseases, Pediatric National Hospital

Of the 63 children with MIS-C, 52% are severely ill, with or without the virus detected, with or without the ability to meet Kawasaki disease criteria, with or without detection, etc. , An additional subtype of MIS-C has been identified. Heart abnormality.

Median age (7.25 years) and gender were similar between the MIS-C cohort and the control group, but black (46%) and Latin (35%) children were in the MIS-C group, especially lifesaving. It was overrated for children in need of emergency.

Cardiac complications were more common in children who became severely ill with MIS-C (55% vs. 28%). The findings also showed that MIS-C patients showed distinct cytokine characteristics with significantly higher levels of specific cytokines than controls. This may help you understand what causes the disease and which potential treatments are most effective.

In a review of viral load and antibody biomarkers, researchers found that MIS-C cases with detectable virus had lower viral load than primary SARS-CoV-2 infected cases, but had an alternative diagnosis but were detectable. I found that it was similar to the MIS-C control that was. Virus.

The majority of patients with MIS-C had more detectable SARS-CoV-2 antibodies than controls. This is consistent with the current belief that MIS-C occurs as part of an excessive immune response weeks after primary COVID-19 infection.

Viral sequencing was also performed in the MIS-C cohort and compared with cases of primary COVID-19 infection in a national geographic population of children. Eighty-eight percent of the samples analyzed were classified as GH clades, circulating early in the US and Canadian pandemics, consistent with the high frequency of GH clades first observed in France.

“The fact that there were no significant sequence differences between our MIS-C cohort and the primary COVID cohort is that changes in host genetics and / or immune response are not virus-specific factors, but MIS-C. It suggests that it is likely to be a major determinant of how MIS-C appears. “Dr. Deviasi says,“ As new variants continue to emerge, the frequency of MIS-C. And it will be important to study their effect on severity. “

Researchers are still looking for consensus on the most effective treatments for MIS-C.In a recent editorial New England Journal of Medicine, Dr. DeBiasi calls for a large, well-characterized, prospective cohort study in a single institution and a systematic and long-term follow-up of cardiac and non-cardiac outcomes in children with MIS-C. The data from these studies will be the decisive determinants of the best set of treatment guidelines for immunotherapy to treat MIS-C.