2023, Número 3
<< Anterior Siguiente >>
Acta Pediatr Mex 2023; 44 (3)
Epidemiología, Manifestaciones Clínicas y Fisiopatología del Síndrome Inflamatorio Sistémico en la Infancia
Rodríguez-Lozano AL, Toledo-Salinas CC, Bayardo-Gutiérrez B, Nájera-Velázquez RG
Idioma: Español
Referencias bibliográficas: 95
Paginas: 221-241
Archivo PDF: 397.50 Kb.
RESUMEN
El síndrome multisistémico inflamatorio pediátrico se ha reconocido como una
condición emergente, un nuevo espectro de enfermedad pediátrica asociada a la
infección por SARS-CoV-2. Este síndrome fue identificado inicialmente en Europa y
se denominó PIMS-TS (
Pediatric Inflammatory Multisystem Syndrome – Temporally
associated with SAR-CoV-2) posteriormente en los Estados Unidos de América, se
designó como MIS-C (
Multisystem Inflammatory Syndrome in Children), cuando
en mayo de 2020 la OMS acuñó el término. La incidencia de MIS-C en pacientes
menores de 21 años infectados con SARS-CoV-2 es de 5.1 por 1, 000,000 personasmes
[IC 95% 4.5 a 5-8], y es mayor en los pacientes afroamericanos e hispanos o
latinos con respecto a los caucásicos. En este artículo resumiremos los principales
hallazgos en cuanto a la epidemiología, las manifestaciones clínicas, la fisiopatología
y finalmente presentaremos información acerca de si MIS-C pertenece al espectro
de la enfermedad de Kawasaki.
REFERENCIAS (EN ESTE ARTÍCULO)
Riphagen S, Gomez X, González-Martínez C, WilkinsonN, Theocharis P. Hyperinflammatory shock in childrenduring COVID-19 pandemic. Lancet 2020; 395: 1607-8.DOI:10.1016/ S0140-6736(20)31094-1.
Verdoni L, Mazza A, Gervasoni A, Martelli L, Ruggeri M,Ciuffreda M, et al. An outbreak of severe Kawasaki-like diseaseat the Italian epicentre of the SARS-CoV-2 epidemic:an observational cohort study. Lancet 2020; 395: 1771-78.DOI:10.1016/ S0140-6736(20)31103-X.
Pain C, Felsenstein S, Cleary G, Mayell S, Conrad K, HaraveS, et al. Novel paediatric presentation of COVID-19 withARDS and cytokine storm syndrome without respiratorysymptoms. Lancet 2020; 2: e376-e379. DOI: 10.1016/S2665-9913(20)30137-5.
White M, Tiesman B, Handforth J, Kenny J. Paediatricinflammatory multisystem syndrome temporally associatedwith SARS-CoV-2 (PIMS-TS): The Evelina Experience.Arch Dis Child 2020; 105: 1025-27. DOI: 10.1136/archdischild-2020–319554.
Royal College of Paediatrics and Child Health. Guidance:paediatric multisystem inflammatory syndrome temporallyassociated with COVID-19. https://www.rcpch.ac.uk/resources/guidance-paediatric-multisystem-inflammatorysyndrome-temporally-associated-COVID-.
World Health Organization. Multisystem inflammatorysyndrome in children and adolescents with COVID-19.Available from: https://www.who.int/publications/i/item/multisystem-inflammatory-syndrome-in-children-andadolescents-with-COVID-19. 2020.
Information for Healthcare Providers about MultisystemInflammatory Syndrome in Children (MIS-C). https://www.cdc.gov/mis-c/hcp/.
Riphagen S. Understanding COVID and the associated postinfectioushyper-inflammatory state (PIMS-TS) in children.Med Hypotheses 2020; 144: 110029. DOI: 10.1016/j.mehy.2020.110029.
Lee PY, Day-Lewis M, Henderson LA, Friedman KG, Lo J,Roberts JE, et al. Distinct clinical and immunological featuresof SARS–CoV-2–induced multisystem inflammatorysyndrome in children. J Clin Invest 2020; 130: 5942-50.DOI: /10.1172/JCI141113.
Dufort EM, Koumans EH, Chow EJ, Rosenthal EM, et al. MultisystemInflammatory Syndrome in Children in New YorkState. N Engl J Med 2020. DOI: 10.1056/NEJMoa2021756.
Lee EH, Kepler KL, Geevarughese A, Paneth-Pollak R, DorsinvilleMS, Ngai S, et al. Race/Ethnicity Among ChildrenWith COVID-19–Associated Multisystem InflammatorySyndrome. JAMA Netw O 2020; 3: e2030280. DOI: 10.1001/jamanetworkopen.2020.30280.
Godfred-Cato S, Bryant B, Leung J, Oster M, Conklin L,Abrams J. COVID-19–Associated Multisystem InflammatorySyndrome in Children — United States, March–July 2020.MMWR Morb Mortal Wkly Rep 2020; 69: 1074-80. DOI:10.15585/mmwr.mm6932e2.
Whittaker E, Bamford A, Kenny J, Kaforou M, et al.Clinical Characteristics of 58 Children with a PediatricInflammatory Multisystem Syndrome Temporally Associatedwith SARS-CoV-2. JAMA 2020; 259-69. DOI: 10.1001/jama.2020.10369.
Antúnez-Montes OY, Escamilla MI, Figueroa-Uribe AF,Arteaga-Menchaca E, et al. COVID-19 and MultisystemInflammatory Syndrome in Latin American Children.Pediatr Infect Dis J 2021; 40: e1-e6. DOI: 10.1097/INF.0000000000002949.
Payne AB, Gilani Z, Godfred-Cato S, Belay ED, Feldstein LR,Patel MM, et al. Incidence of Multisystem InflammatorySyndrome in Children Among US Persons Infected WithSARS-CoV-2. JAMA Netw open 2021; 4: e2116420.
Swann O V, Holden KA, Turtle L, Pollock L, Fairfield CJ, etal. Clinical characteristics of children and young peopleadmitted to hospital with COVID-19 in United Kingdom:Prospective multicentre observational cohort study. BMJ2020; 370: m3249. DOI:10.1136/bmj.m3249.
Torres JP, Izquierdo G, Acuña M, Pavez D, Reyes F. Multisysteminflammatory syndrome in children (MIS-C): Reportof the clinical and epidemiological characteristics of casesin Santiago de Chie during the SARS-CoV-2 pandemic. Int JInfect Dis 2020; 100: 75-81. DOI: 10.1016/j.ijid.2020.08.06.
Lima-Setta F, Magalhães-Barbosa MC de, Rodrigues-SantosG, Figueiredo EA das N, Jacques M de L, Zeitel R de S, etal. Multisystem inflammatory syndrome in children (MISC)during SARS-CoV-2 pandemic in Brazil: a multicenter,prospective cohort study. J Pediatr 2020. DOI: 10.1016/j.jped.2020.10.008.
Aronoff SC, Hall A, Del Vecchio MT. The Natural Historyof Severe Acute Respiratory Syndrome Coronavirus 2–RelatedMultisystem Inflammatory Syndrome in Children:A Systematic Review. J Pediatr Infect Dis Soc 2020. DOI:10.1093/jpids/piaa112/5905175.
Radia T, Williams N, Agrawal P, Harman K, Weale J, Cook J.Multi-system inflammatory syndrome in children & adolescents(MIS-C): A systematic review of clinical featuresand presentation. Paediatr Respir Rev 2020. DOI: 10.1016/j.prrv.2020.08.001.
Ahmed M, Advani S, Moreira A, Zoretic S, Martinez J,Chorath K, et al. Multisystem inflammatory syndrome inchildren: A systematic review. EClinicalMedicine 2020; 26:100527. DOI: 10.1016/j.eclinm.2020.100527.
Kaushik A, Gupta S, Sood M, Sharma S, Verma S. A systematicreview of multisystem inflammatory syndromein children associated with SARS-CoV-2 infection. PediatrInfect Dis J 2020; 39: e340-e346. DOI: 10.1097/INF.0000000000002888.
Panigrahy N, Policarpio J, Ramanathan R. Multisysteminflammatory syndrome in children and SARS-CoV-2: Ascoping review. J Pediatr Rehabil Med 2020; 13: 301-16.DOI: 10.3233/PRM-200794.
Miller J, Cantor A, Zachariah P, Ahn D, Martinez M,Margolis KG. Gastrointestinal Symptoms as a Major PresentationComponent of a Novel Multisystem InflammatorySyndrome in Children That Is Related to CoronavirusDisease 2019: A Single Center Experience of 44 Cases.Gastroenterology 2020; 159: 1571-74. DOI: 10.1053/j.gastro.2020.05.079.
Stevens JP, Brownell JN, Freeman AJ, Bashaw H. COVID-19-associated Multisystem Inflammatory Syndrome inChildren Presenting as Acute Pancreatitis. JPGN 2020; 71:669-671. DOI: 10.1097/MPG.0000000000002860.
Cantor A, Miller J, Zachariah P, DaSilva B, Margolis K,Martinez M. Acute Hepatitis Is a Prominent Presentationof the Multisystem Inflammatory Syndrome in Children: ASingle-Center Report. Hepatology 2020; 72: 1522-27. DOI:10.1002/HEP.31526.
Dionne A, Mah DY, Son MBF, Lee PY, Henderson L, BakerAL, et al. Atrioventricular Block in Children with MultisystemInflammatory Syndrome. Pediatrics 2020; 146:e2020009704. DOI: 10.1542/peds.2020-009704.
Clark BC, Sanchez-de-Toledo J, Bautista-Rodriguez C,Choueiter N, Lara D, Kang H, et al. Cardiac AbnormalitiesSeen in Pediatric Patients During the SARS-CoV2 Pandemic:An International Experience. J Am Hear Assoc 2020; 9:e018007. DOI: 10.1161/jaha.120.018007.
Belhadjer Z, Méot M, Bajolle F, Khraiche D, Legendre A,Abakka S, et al. Acute Heart Failure in Multisystem InflammatorySyndrome in Children in the Context of GlobalSARS-CoV-2 Pandemic. Circulation 2020; 142: 429-36. DOI:10.1161/CIRCULATIONAHA.120.048360.
Minocha PK, Phoon CKL, Verma S, Singh RK. Cardiac Findingsin Pediatric Patients With Multisystem InflammatorySyndrome in Children Associated With COVID-19. ClinPediatr 2020; DOI: 10.1177/0009922820961771.
Alsaied T, Tremoulet AH, Burns JC, Saidi A, Dionne A, LangSM, et al. Review of Cardiac Involvement in MultisystemInflammatory Syndrome in Children. Circulation 2020. DOI:10.1161/CIRCULATIONAHA.120.049836.
Ramcharan T, Nolan O, Lai CY, Prabhu N, Krishnamurthy R,Richter AG, et al. Paediatric Inflammatory Multisystem Syndrome:Temporally Associated with SARS-CoV-2 (PIMS-TS):Cardiac Features, Management and Short-Term Outcomesat a UK Tertiary Paediatric Hospital. Pediatr Cardiol 2020;41: 1391-401. 10.1007/s00246-020-02391–2.
Sperotto F, Friedman KG, Son MBF, VanderPluym CJ,Newburger JW, Dionne A. Cardiac manifestations in SARSCoV-2-associated multisystem inflammatory syndrome inchildren: a comprehensive review and proposed clinicalapproach. Eur J Pediatr. 2020;DOI: 10.1007/s00431-020-03766-6.
Valverde I, Singh Y, Sanchez-de-Toledo J, Theocharis P,Chikermane A, Di Filippo S, et al. Acute CardiovascularManifestations in 286 Children with Multisystem InflammatorySyndrome Associated with COVID-19 Infectionin Europe. Circulation. 2020;DOI: 10.1161/CIRCULATIONAHA.120.050065.
Rodriguez-Gonzalez M, Castellano-Martinez A, Cascales-Poyatos HM, Perez-Reviriego AA. Cardiovascular impactof COVID-19 with a focus on children: A systematic review.World J Clin Cases. 2020;8:5250-83. DOI: 10.12998/wjcc.v8.i21.5250.
Regan W, O’Byrne L, Stewart K, Miller O, Pushparajah K.Electrocardiographic changes in children with multisysteminflammation associated with COVID-19. J Pediatr.2020;DOI: 10.1016/j.jpeds.2020.12.033.
Caro-Patón G de L, de Azagra-Garde AM, García-SalidoA, Cabrero-Hernández M, Tamariz A, Nieto-Moro M.Shock and Myocardial Injury in Children With MultisystemInflammatory Syndrome Associated WithSARS-CoV-2 Infection: What We Know. Case Series andReview of the Literature. J Intensive Care Med. 2020;DOI:10.1177/0885066620969350.
Matsubara D, Kauffman H, Wang Y, Calderon-Anyosa R,Nadaraj S, Elias M, et al. Echocardiographic Findings inPediatric Multisystem Inflammatory Syndrome AssociatedWith COVID-19 in the United States. JACC. 2020;76:1947-61. DOI: /10.1016/j.jacc.2020.08.056.
Young TK, Shaw KS, Shah JK, Noor A, Alperin RA, RatnerAJ, et al. Mucocutaneous Manifestations of MultisystemInflammatory Syndrome in Children During the COVID-19Pandemic. JAMA Dermatol 2020; 10016: e204779.DOI:10.1001/jamadermatol.2020.4779.
Lad SS, Kait SP, Suryawanshi PB, Mujawar J, Lad P, KhetreR, et al. Neurological Manifestations in Pediatric InflammatoryMultisystem Syndrome Temporally Associated withSARS-CoV-2 (PIMS-TS). Indian J Pediatr 2020. DOI: 10.1007/s12098-020-03530-6.
De Paulis M, Oliveira DBL, Vieira RP, Pinto IC, MacHado RRG,Cavalcanti MP, et al. Multisystem inflammatory syndromeassociated with COVID-19 with neurologic manifestationsin a child: A brief report. Pediatr Infect Dis J 2020; 39: e321-e324. DOI: 10.1097/INF.0000000000002834.
Verkuil LD, Liu GT, Brahma VL, Avery RA. Pseudotumorcerebri syndrome associated with MIS-C: a case report.Lancet 2020; 396: DOI: 10.1016/ S0140-6736(20)31725-6.
Feng Z, Bao Y, Yang Y, Zheng Y, Shen K. Severe Acute RespiratorySyndrome Coronavirus 2-Induced MultisystemInflammatory Syndrome in Children. Pediatr Invest 2020;4: 257-62. DOI: 10.1002/ped4.12225.
Lee M, Hilado M, Sotelo S, Opas LM, Im DD. Acute KidneyInjury in Multisystem Inflammatory Syndrome in Children(MIS-C): a Case Report. SN Compr Clin Med 2020. DOI:10.1007/s42399-020-00647-9.
McCulloch M, Abugrain K, Mosalakatane T, CoetzeeA, Webb K, Scott C. Peritoneal dialysis for treatmentof acute kidney injury in a case of paediatric inflammatorymultisystem syndrome temporally associatedwith SARS-CoV-2. Perit Dial Int 2020; 40: 515-517. DOI:10.1177/0896860820953716.
Henderson LA, Canna SW, Friedman KG, Gorelik M, LapidusSK, Bassiri H, et al. American College of Rheumatology ClinicalGuidance for Multisystem Inflammatory Syndrome inChildren Associated With SARS–CoV-2 and Hyperinflammationin Pediatric COVID-19: Version 1. Arthritis Rheumatol2020; 72: 1791-805.
Hennon T, Penque M, Abdul-Aziz R, Alibrahim O, McGreevyM, Prout A. COVID-19 associated Multisystem InflammatorySyndrome in Children (MIS-C) guidelines; a WesternNew York approach. Prog Pediatr Cardiol 2020. DOI:10.1016/j.ppedcard.2020.101232.
Nijman RG, De Guchtenaere A, Koletzko B, Ross RussellR, Copley S, Titomanlio L, et al. Pediatric InflammatoryMultisystem Syndrome: Statement by the Pediatric Sectionof the European Society for Emergency Medicine andEuropean Academy of Pediatrics. Front Pediatr 2020; 8.DOI: 10.3389/fped.2020.00490.
Perez-Toledo M, Faustini S, Jossi S, Shields A, KanthimathinathanHK, Allen J, et al. Serology confirms SARS-CoV-2 infectionin PCR-negative children presenting with PaediatricInflammatory Multi-System Syndrome. medRxiv [Preprint].2020. DOI: 10.1101/2020.06.05.20123117.
Henderson L, Canna S, Friedman K, Gorelik M, Lapidus S,Bassiri H, et al. American College of Rheumatology ClinicalGuidance for Pediatric Patients with Multisystem InflammatorySyndrome in Children (MIS-C) Associated withSARS-CoV-2 and Hyperinflammation in COVID-19. Version2. Arthritis Rheumatol. 2020. DOI: 10.1002/art.41616.
Abrams J, Godfred-Cato S, Oster M, Chow E, Koumans E,Bryant B, et al. Multisystem Inflammatory Syndrome in ChildrenAssociated with Severe Acute Respiratory SyndromeCoronavirus 2: A Systematic Review. J Pediatr 2020; 226:45-54. DOI: 10.1016/j.jpeds.2020.08.003 45.
Blondiaux E, Parisot P, Redheuil A, Tzaroukian L, Levy Y,Sileo C. Cardiac MRI of Children with Multisystem InflammatorySyndrome (MIS-C) Associated with COVID-19: CaseSeries. Radiology 2020; 297: E283-E288. DOI: 10.1148/radiol.2020202288.
Gkoutzourelas A, Bogdanos D, Sakkas L. Kawasaki Diseaseand COVID-19. Mediterr J Rheumatol 2020; 31: 268-74.DOI: 10.31138/mjr.31.3.268.
Singh-Grewal D, Lucas R, Macartney K, Cheng A, Wood N,Ostring G. Update on the COVID‐19‐associated inflammatorysyndrome in children and adolescents; paediatric inflammatorymultisystem syndrome-temporally associatedwith SARS-CoV-2. J Pediatr Child Heal 2020; 56: 1173-77.DOI: 10.1111/jpc.15049.
McCrindle B, Manlhiot C. SARS-CoV-2–Related InflammatoryMultisystemSyndrome in Children Different or SharedEtiology and Pathophysiology as Kawasaki Disease? JAMA2020; 324. DOI: 10.1001/jama.2020.10370.
Lami F, Scalabrini I, Lucaccioni L, Iughetti L. The “perfect”storm: Current evidence on pediatric inflammatory multisystemdisease during sars-cov-2 pandemic. Acta Biomed2020; 91: e2020034. DOI: 10.23750/abm.v91i3.10360.
Loke Y, Berul C, Harahsheh A. Multisystem inflammatorysyndrome in children: Is there a linkage to Kawasakidisease? Trends Cardiovasc Med 2020; 30: 389-96. DOI:10.1016/j.tcm.2020.07.004.
Soma V, Shust G, Ratner A. Multisystem InflammatorySyndrome in Children. Curr Opin Pediatr 2021; 32.DOI:10.1097/MOP.0000000000000974.
Santos BS Dos, Santos FS Dos, Ribeiro ER. Clinical-EpidemiologicalRelation Between Sars-Cov-2 and Kawasaki Disease:an Integrative Literature. Rev Paul Pediatr 2021; 39:e2020217. DOI: 10.1590/1984-0462/2021/39/2020217.
Berardicurti O, Conforti A, Ruscitti P, Cipriani P, GiacomelliR. The wide spectrum of Kawasaki-like disease associatedwith SARS-CoV-2 infection. Expert Rev Clin Immunol 2020.DOI: 10.1080/1744666X.2021.1847643.
Pouletty M, Borocco C, Ouldali N, Caseris M, Basmaci R,Lachaume N, et al. Paediatric multisystem inflammatorysyndrome temporally associated with SARS-CoV-2 mimickingKawasaki disease (Kawa-COVID-19): A multicentrecohort. Ann Rheum Dis 2020; 79: 999-1006. DOI: 10. 1136/annrheumdis-2020–218110.
Sethuraman U, Kannikeswaran N, Ang J, Singer A. Multisysteminflammatory syndrome in children associatedwith novel coronavirus SARS-CoV-2: Presentations to apediatric emergency department in Michigan. Am J EmergMed 2021; 39: 164-7. DOI: 10.1016/j.ajem.2020.10.035.
Saez-de-Ocariz M, Gámez-González L, Rivas-Larrauri F. Kawasakidisease mimickers. Pediatr Int 2021. DOI: 10.1111/ped.14561.
Tam H, El Tal T, Go E, Yeung RSM. Pediatric inflammatorymultisystem syndrome temporally associated with COVID-19: A spectrum of diseases with many names. CMAJ2020; 192: E1093-E1096. DOI: 10.1503/cmaj.201600.
Corwin DJ, Sartori LF, Chiotos K, Odom John AR, CohnK, Bassiri H, et al. Distinguishing multisystem inflammatorysyndrome in children from kawasaki disease andbenign inflammatory illnesses in the SARS-CoV-2 pandemic.Pediatr Emer Care 2020; 36: 554-58. DOI: 10.1097/PEC.0000000000002248.
Koné-Paut I, Cimaz R. Is it Kawasaki shock syndrome,Kawasaki-like disease or pediatric inflammatory multisystemdisease? The importance of semantic in the eraof COVID-19 pandemic. RMD Open 2020; 6: e001333.DOI:10.1136/rmdopen-2020-001333.
Schroeder AR, Wilson KM, Ralston SL. COVID-19 and KawasakiDisease: Finding the Signal in the Noise. Hosp Pediatr.2020;DOI: 10.1542/hpeds.2020-000356.
Kabeerdoss J, Pilania RK, Karkhele R, Kumar TS, Danda D,Singh S. Severe COVID-19, multisystem inflammatory syndromein children, and Kawasaki disease: immunologicalmechanisms, clinical manifestations and management.Rheumatol Int 2020. DOI: 10.1007/s00296-020-04749-4.
Tsabouri S, Makis A, Kosmeri C, Siomou E. Risk Factorsfor Severity in Children with Coronavirus Disease 2019 AComprehensive Literature Review. Pediatr Clin N Am 2021;68: 321-38. DOI:10.1016/j.pcl.2020.07.014.
Pereira M, Litvinov N, Farhat S, Eisencraft A, Gibelli M,Carvalho W. Severe clinical spectrum with high mortality inpediatric patients with COVID-19 and multisystem inflammatorysyndrome. Clinics 2020; 75: e2209. DOI: 10.6061/clinics/2020/e2209.
Fernandes D, Oliviera C, Guerguis S, Eisenberg R, Choi J,Kim M. Severe Acute Respiratory Syndrome Coronavirus2 Clinical Syndromes and Predictors of Disease Severityin Hospitalized Children and Youth. J Pediatr 2020. DOI.10.1016/j.jpeds.2020.11.016.
Rothan HA, Byrareddy SN. The potential threat of multisysteminflammatory syndrome in children during theCOVID-19 pandemic. Pediatr Allergy Immunol 2020; 1-6.DOI: 10.1111/pai.13361.
Felsenstein S, Hedrich C. SARS-CoV-2 infections in childrenand young people. Clin Immunol 2020; 220. DOI: 10.1016/j.clim.2020.108588.
Galipeau Y, Greig M, Liu G, Driedger M, Langlois M-A.Humoral Responses and Serological Assays in SARS-CoV-2Infections. Front Immunol 2020; 11: 610688. DOI: 10.3389/fimmu.2020.610688.
Vojdani A, Kharrazian D. Potential antigenic crossreactivitybetween SARS-CoV-2 and human tissue witha possible link to an increase in autoimmune diseases.Editorial. Clin Immunol 2020; 217: 108480. DOI: 10.1016/j.clim.2020.108480.
Saratannon N, Dik W, Chatchatee P, van Hagen P. COVID-19in children: Heterogeneity within the disease and hypotheticalpathogenesis. Asian Pac J Allergy Immunol 2020;38: 170-77. DOI: 10.12932/AP-170720-920.
Taefehshokr N, Taefehshokr S, Heit B. Mechanisms ofdysregulated humoral and cellular immunity by SARSCoV-2. Pathogens 2020; 9: 1027. DOI: 10.3390/pathogens9121027.
Wan Y, Shang J, Sun S, Tai W, Chen J, Geng Q, et al. MolecularMechanism for Antibody-Dependent Enhancementof Coronavirus Entry. J Virol 2020; 94: e02015-19.DOI:10.1128/JVI.02015-19.
Merad M, Martin JC. Pathological inflammation in patientswith COVID-19: a key role for monocytes and macrophages.Nat Rev Immunol 2020; 20: 355-62. DOI: 10.1038/s41577-020-0331-4.
Feng Z, Diao B, Wang R, Wang G, Wang C, Tan Y, et al.The Novel Severe Acute Respiratory Syndrome Coronavirus2 (SARS-CoV-2) Directly Decimates Human Spleensand Lymph Nodes. medRxiv [Preprint]. 2020. DOI:10.1101/2020.03.27.20045427.
Gruber C, Patel R, Trachman R, Lepow L, Amanat F, KrammerF. Mapping Systemic Inflammation and AntibodyResponses in Multisystem Inflammatory Syndromein Children (MIS-C). medRxiv [Preprint]. 2020. DOI:10.1101/2020.07.04.20142752.
Rowley A. Understanding SARS-CoV-2-related multisysteminflammatory syndrome in children. Nat Rev Immunol2020; 20: 453-54. DOI: 10.1038/s41577-020-0367-5.
Moreews M, Le Gouge K, Khaldi-Plassart S, Pescarmona R,Mathieu A, Malcus C. Polyclonal expansion of TCR Vbeta21.3+ CD4+ and CD8+ T cells is a hallmark of MultisystemInf lammatory Syndrome in Children.pdf. Sci Immunol2021. DOI: 10.1126/sciimmunol.abh.
Roe K. A viral infection explanation for Kawasaki disease in generaland for COVID related Kawasaki disease symptoms. Inflammopharmacology2020. DOI: 10.1007/s10787-020-00739-x.
Consiglio C, Cotugno N, Sardh F, Pou C, Amodio D, RodriguezL, et al. The Immunology of Multisystem InflammatorySyndrome in Children with COVID-19. Cell 2020; 183: 968-81. DOI: 10.1016/j.cell.2020.09.016.
Icenogle T. COVID-19: Infection or Autoinmmunity. FrontImmunol 2020; 11. DOI: 10.3389/fimmu.2020.02055.
Beckmann N, Comella P, Cheng E, Lepow L, Beckmann A,Mouskas K, et al. Cytotoxic lymphocytes are dysregulated inmultisystem inflammatory syndrome in children. medRxiv[Preprint]. 2020. DOI: 10.1101/2020.08.29.20182899.
Cheng M, Zhang S, Porrit R, Arditi M, Bahar I. An insertionunique to SARS-CoV-2 exhibits superantigenic characterstrengthened by recent mutations. bioRxiv [preprint].2020. DOI: 10.1101/2020-05.21.109272.
Cheng M, Zhang S, Porritt R, Rivas M, Paschold L, WillscherE, et al. Superantigenic character of an insert unique toSARS-CoV-2 spike supported by skewed TCR repertoire inpatients wirh hyperinflammation. PNAS 2020; 117. DOI:10.1073/pnas.2010722117.
Rowley A, Shulman S, Arditi M. Immune pathogenesis ofCOVID-19–related multisystem inflammatory syndrome in children.J Clin Invest 2020; 130: 5619-21. DOI: 10.1172/JCI143840.
Noval Rivas M, Porritt R, Cheng M, Bahar I, ArditiM. Multisystem Inflammatory Syndrome in Childrenand Long COVID: The SARS-CoV-2 Viral SuperantigenHypothesis. Front Immunol 2022; 13. DOI: 10.3389/fimmu.2022.941009.
Weisberg SP, Connors T, Zhu Y, Baldwin M, Lin W-H, WontakalS, et al. Antibody responses to SARS-CoV2 are distinctin children with MIS-C compared to adults with COVID-19.medRxiv 2020. DOI: 10.1101/2020.07.12.20151068.
Sorg AL, Schönfeld V, Siedler A, Hufnagel M, DoenhardtM, Diffloth N, et al. SARS-CoV-2 variants and the risk ofpediatric inflammatory multisystem syndrome temporallyassociated with SARS-CoV-2 among children in Germany.Infection 2022. DOI: 10.1007/s15010-022-01908-6.
Cohen J, Carter M, Cheung C, Ladhani S. Lower Risk ofMultisystem Inflammatory Syndrome in Children Withthe Delta and Omicron Variants of Severe Acute RespiratorySyndrome Coronavirus 2. Clin Infect Dis 2022; 2. DOI:10.1093/cid/ciac553.
Holm M, Espenhain L, Glenthøj J, Samsø Schmidt L, BritNordly S, Hartling U. Risk and Phenotype of MultisystemInflammatory Syndrome in Vaccinated and UnvaccinatedDanish Children Before and During the OmicronWave.JAMA Ped 2022; 176: 287.e1-287.e3.