Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Dec 5;94(6):e2023233.
doi: 10.23750/abm.v94i6.14788.

Long-term outcomes and immune profiling in children with multisystem inflammatory syndrome (MIS-C)

Indira Jaxybayeva  1 , Riza Boranbayeva  2 , Minira Bulegenova  3 , Nataliya Urazalieva  4 , Valentin Gerein  5 , Lyazat Manzhuova  6
Affiliations

Long-term outcomes and immune profiling in children with multisystem inflammatory syndrome (MIS-C)

Indira Jaxybayeva et al. Acta Biomed. .

Abstract

Background and aim: Existing follow-up data after MIS-C is limited.

Purpose of the study: to investigate the long-term consequences in children who have undergone MIS-C.

Methods: The retrospective study included 93 children. The identified changes were divided into the following periods: occurred within first 6 months, 1 year, 2 years, and more than 2 years after MIS-C. Besides, 31 children underwent prospective immunophenotyping of peripheral blood and the determination of cytokines during the acute period of the disease and after discharge.

Results: Outpatient monitoring events included pneumonia (9.6%), somatic disorder syndrome (11.8%), visual impairment (7.5%), joint damage (6.6%), weight changes (2.2%), and MIS-C recurrence (2.2%). A study of the cardiovascular system showed a statistically significant decrease in the frequency of the right and left heart dilatation, left ventricular dysfunction, pericarditis, pulmonary arterial hypertension, coronaritis, mitral regurgitation. But at the same time an increase in pulmonary and tricuspid valve regurgitation and arrhythmias compared with the acute period was detected. Most of the changes took place within first year of observation. Immune profiling showed reconstitution of CD3, CD4 T-lymphocytes, NK-cells, maintenance of a high relative value of CD8, reduction of CD19+ B-cells, expression of CD3-HLA-DR+, CD25, CD279, CD95.

Conclusions: After the history of MIS-C, children in the long-term follow-up had various somatic disorders and disease recurrence. Most patients (64.1%) showed subclinical signs of myocardial involvement within first year of observation. Low expression of CD95 may justify an certain role in the pathogenesis of the disease.

PubMed Disclaimer

Conflict of interest statement

Each author declares that he or she has no commercial associations (e.g., consulting services, shareholding, equity interest, patent/license agreement, etc.) that could create a conflict of interest in connection with this study.

Figures

Figure 1.
Figure 1.
Registered cases of children with MIS-C in the Republic of Kazakhstan.
Figure 2.
Figure 2.
A comparative analysis of post-MIS-C illnesses by observation periods.
Figure 3.
Figure 3.
Coverage of children under outpatient ECHO and EGG monitoring examinations over time.
Figure 4.
Figure 4.
Dynamics of detected changes on ECHO (a) and ECG (b) in children after previous MIS-C, by periods of examination.
Figure 5.
Figure 5.
Dynamic changes in cytokine parameters in children with MIS-C. For diagrams a,b,c,d,e, the upper boundary of the rectangle represents the median, and the whiskers represent the interquartile range (25th-75th percentile values). The Wilcoxon rank-sum test was used to determine statistically significant changes in all parameters.
See this image and copyright information in PMC

References

    1. Noval Rivas M, Porritt RA, Cheng MH, Bahar I, Arditi M. Multisystem inflammatory syndrome in children and long COVID: the SARS-CoV-2 viral superantigen hypothesis. Front Immunol. 2022 Jul 7;13:941009. doi: 10.3389/fimmu.2022.941009. - PMC - PubMed
    1. Das N, Hill R, Trivedi M, et al. Longitudinal assessment of cardiac function following multisystem inflammatory syndrome in children associated with COVID-19. Pediatr Cardiol. 2023 Mar;44(3):607–617. doi: 10.1007/s00246-022-02972-3. - PMC - PubMed
    1. Sezer M, Çelikel E, Tekin ZE, et al. Multisystem inflammatory syndrome in children: clinical presentation, management, and short- and long-term outcomes. Clin Rheumatol. 2022 Dec;41(12):3807–3816. doi: 10.1007/s10067-022-06350-5. - PMC - PubMed
    1. Lin J, Harahsheh AS, Raghuveer G, et al. Emerging insights into the pathophysiology of multisystem inflammatory syndrome associated with COVID-19 in children. Can J Cardiol. 2023 Jan 7 S0828-282X(23)00004-1. doi: 10.1016/j.cjca.2023.01.002. - PMC - PubMed
    1. Rajamanickam A, Nathella PK, Venkataraman A, et al. Unique cellular immune signatures of multisystem inflammatory syndrome in children. PLoS Pathog. 2022 Nov 2;18(11):e1010915. doi: 10.1371/journal.ppat.1010915. - PMC - PubMed