Inflammatory syndromes associated with SARS-CoV-2 infection: dysregulation of the immune response across the age spectrum

Multisystem inflammatory syndrome in children and adults (MIS-C/A): Case definition & guidelines for data collection, analysis, and presentation of immunization safety data

“…However, it has become clear that a fraction of children develop a life-threatening hyperinflammatory state 4–6 weeks after infection with primary COVID-19 termed Multisystem Inflammatory Syndrome in Children (MIS-C) [3] . A similar condition has also been reported as a rare complication of COVID-19 in adults (MIS-A) [4] , [5] . It is currently unknown if MIS-C/A might follow immunization against SARS-CoV-2, but a need exists to define this potential entity for monitoring as an adverse event following immunization (AEFI).…”

“…From early in the pandemic, it was clear that a subset of adult patients experiences a severe hyperinflammatory response during primary SARS-CoV-2 infection [24] . After MIS-C was recognized, a similar presentation in adult patients, MIS-A, was appreciated as a distinct clinical entity [4] , [5] , [25] . MIS-A has been recognized as a severe illness requiring hospitalization in a person aged ≥21 years, with laboratory evidence of current or previous (within 12 weeks) SARS-CoV-2 infection, severe extrapulmonary organ dysfunction (including thrombosis), laboratory evidence of severe inflammation, and absence of severe respiratory disease [4] .…”

Interleukin-8 as a Biomarker for Disease Prognosis of Coronavirus Disease-2019 Patients

“…In addition, intensive care unit (ICU) patients with more severe disease process have higher plasma levels of IL-2, IL-7, IL-10, granulocyte colony stimulating factor (GCSF), IP-10, MCP-1, macrophage inflammatory protein-1a (MIP-1A), and tumor necrosis factor-α (TNF-α) than non-ICU patients ( 21 – 24 ). Among severe COVID-19 cases, the majority of the patients with respiratory distress syndrome were associated with high systemic IL-1β, TNF-α, and IL-6 levels ( 25 , 26 ). These reports suggest a possible connection between proinflammatory cytokine induction and adverse effects of COVID-19.…”

Ig-responsive relapsing inflammatory syndrome following COVID-19 in a kidney transplant recipient

“… 2 Delayed inflammatory syndromes have been similarly recognized in adults (MIS-A), with fewer than 30 cases previously reported. 3 , 4 We herein describe the first relapsing form of MIS-A post–coronavirus disease 2019 (COVID-19) pneumonia in a kidney transplant recipient.…”

“…MIS-A is seldom reported and is currently defined as an illness requiring hospitalization in a person older than 21 years with a positive test for current or previous SARS-CoV-2 infection within the preceding 12 weeks, severe extrapulmonary organ dysfunction (cardiac, gastrointestinal, dermatologic, or neurologic symptoms), associated with laboratory markers consistent with hyperinflammation in the absence of severe respiratory symptoms. 4 Pathogenesis of MIS, regardless of patient age, is still unknown. A role of autoimmunity induced by SARS-CoV-2 has been proposed in children.…”