{"doi":"10.1093/infdis/jiab285","title":"Distinct Cytokine and Chemokine Dysregulation in Hospitalized Children With Acute Coronavirus Disease 2019 and Multisystem Inflammatory Syndrome With Similar Levels of Nasopharyngeal Severe Acute Respiratory Syndrome Coronavirus 2 Shedding","abstract":"BACKGROUND: Multisystem inflammatory syndrome in children (MIS-C) is a severe clinical phenotype of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection that remains poorly understood. METHODS: Hospitalized children <18 years of age with suspected coronavirus disease 2019 (COVID-19) (N = 53) were recruited into a prospective cohort study; 32 had confirmed COVID-19, with 16 meeting the US Centers for Disease Control criteria for MIS-C. Differences in nasopharyngeal viral ribonucleic acid (RNA) levels, SARS-CoV-2 seropositivity, and cytokine/chemokine profiles were examined, including after adjustments for age and sex. RESULTS: The median ages for those with and without MIS-C were 8.7 years (interquartile range [IQR], 5.5-13.9) and 2.2 years (IQR, 1.1-10.5), respectively (P = .18), and nasopharyngeal levels of SARS-CoV-2 RNA did not differ significantly between the 2 groups (median 63 848.25 copies/mL versus 307.1 copies/mL, P = .66); 75% of those with MIS-C were antibody positive compared with 44% without (P = .026). Levels of 14 of 37 cytokines/chemokines (interleukin [IL]-1RA, IL-2RA, IL-6, IL-8, tumor necrosis factor-α, IL-10, IL-15, IL-18, monocyte chemoattractant protein [MCP]-1, IP-10, macrophage-inflammatory protein [MIP]-1α, MCP-2, MIP-1β, eotaxin) were significantly higher in children with MIS-C compared to those without, irrespective of age or sex (false discovery rate <0.05; P < .05). CONCLUSIONS: The distinct pattern of heightened cytokine/chemokine dysregulation observed with MIS-C, compared with acute COVID-19, occurs across the pediatric age spectrum and with similar levels of nasopharyngeal SARS-CoV-2 RNA.","journal":"The Journal of Infectious Diseases","year":2021,"id":158817,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":44,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9394,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":668827,"name":"Theodore Kouo","orcid":null,"position":1,"is_corresponding":false},{"id":355238,"name":"Andrew H. Karaba","orcid":"0000-0003-2785-317X","position":2,"is_corresponding":false},{"id":506158,"name":"Oren Gordon","orcid":"0000-0002-3159-8426","position":3,"is_corresponding":false},{"id":665795,"name":"Katherine Z J Fenstermacher","orcid":null,"position":4,"is_corresponding":false},{"id":668828,"name":"Jeanette Beaudry","orcid":null,"position":5,"is_corresponding":false},{"id":668286,"name":"Jessica Rubens","orcid":"0000-0001-9198-9149","position":6,"is_corresponding":false},{"id":668829,"name":"Christine C. Atik","orcid":null,"position":7,"is_corresponding":false},{"id":351832,"name":"Weiqiang Zhou","orcid":"0000-0001-9396-9571","position":8,"is_corresponding":false},{"id":233094,"name":"Hongkai Ji","orcid":"0000-0002-6480-0141","position":9,"is_corresponding":false},{"id":474744,"name":"Xueting Tao","orcid":"0000-0003-1012-208X","position":10,"is_corresponding":false},{"id":24907,"name":"Dhananjay Vaidya","orcid":"0000-0002-7164-1601","position":11,"is_corresponding":false},{"id":251887,"name":"Heba H. Mostafa","orcid":"0000-0002-0274-8966","position":12,"is_corresponding":false},{"id":108424,"name":"Patrizio Caturegli","orcid":"0000-0001-6768-6308","position":13,"is_corresponding":false},{"id":391331,"name":"Paul W. Blair","orcid":"0000-0002-3817-5987","position":14,"is_corresponding":false},{"id":457877,"name":"Lauren Sauer","orcid":null,"position":15,"is_corresponding":false},{"id":355240,"name":"Andrea L. Cox","orcid":"0000-0002-9331-2462","position":16,"is_corresponding":false},{"id":385139,"name":"Deborah Persaud","orcid":"0000-0001-5195-8743","position":17,"is_corresponding":false},{"id":668285,"name":"Nadine Peart Akindele","orcid":"0000-0001-8697-0240","position":0,"is_corresponding":true}],"reference_count":43,"raw_metadata":null,"created_at":"2026-07-18T23:44:30.791367Z","pmid":"34398245","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}