Case Report: Inflammation and Endothelial Injury Profiling of COVID-19 Pediatric Multisystem Inflammatory Syndrome (MIS-C)

Douglas D Fraser; Eric K Patterson; Mark Daley; Gediminas Cepinskas

doi:10.3389/fped.2021.597926

Case Report: Inflammation and Endothelial Injury Profiling of COVID-19 Pediatric Multisystem Inflammatory Syndrome (MIS-C)

Front Pediatr. 2021 Apr 8:9:597926. doi: 10.3389/fped.2021.597926. eCollection 2021.

Authors

Douglas D Fraser^{1

2}, Eric K Patterson¹, Mark Daley^{1

3}, Gediminas Cepinskas^{1

4}

Affiliations

¹ Lawson Health Research Institute, London, ON, Canada.
² Pediatrics, Western University, London, ON, Canada.
³ Computer Science, Western University, London, ON, Canada.
⁴ Medical Biophysics, Western University, London, ON, Canada.

Abstract

Introduction: COVID-19 is associated with a novel multi-system inflammatory syndrome that shares some characteristics with Kawasaki's Disease. The syndrome manifestation is delayed relative to COVID-19 onset, with a spectrum of clinical severity. Clinical signs may include persistent fever, gastrointestinal symptoms, cardiac inflammation and/or shock. Case Presentation: We measured 59 inflammatory and endothelial injury plasma analytes in an adolescent girl that presented with malaise, fever, cough, strawberry tongue and jaundice. Her COVID-19 status was positive with detection of 2 SARS-CoV-2 viral genes using polymerase chain reaction. She was treated with intravenous immunoglobulin prior to blood draw, but our plasma measurements suggested a unique analyte expression pattern associated with inflammation, endothelial injury and microvascular glycocalyx degradation. Conclusions: COVID-19 is associated with a multi-system inflammatory syndrome and a unique inflammatory and endothelial injury signature. Summary: Analyte markers of inflammation and endothelial cell injury might serve as putative biomarkers and/or be investigated further as potential therapeutic targets.

Keywords: COVID-19; MIS-C; children; endothelial injury; inflammation; multisystem.

Publication types

Case Reports