SARS-CoV-2 Polymorphisms and Multisystem Inflammatory Syndrome in Children

Abstract

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Late-Onset COVID-19-Related Multi-System Inflammatory Syndrome in a Middle-Aged Man

“…It is thought that the host factors are the significant contributors to MIS rather than viral factors, according to a study done in London involving children infected with SARS-CoV-2 [ 7 ]. This can be translated into the adult population since they can present similarly.…”

“…Critical COVID-19 is a feature of acute respiratory distress syndrome (ARDS) with or without the multi-inflammatory syndrome [ 10 ]. In contrast, MIS-A manifests with no or minimal pulmonary features, hypoxemia, or radiological evidence of pulmonary involvement [ 7 ]. In addition, MIS-A tends to have a temporal space from the initial COVID-19 infection, usually appearing at least two weeks after the initial infection.…”

Jumping a Moving Train: SARS-CoV-2 Evolution in Real Time

“…Because MIS-C is a late presentation, the virus is often not present or found at very low levels in respiratory secretions. Therefore, whole-genome analysis has been difficult in this condition, and only a few reported sequences are available [ 149 , 150 ]. Although the pathogenesis of MIS-C is not well understood, it has been suggested that components of the virus may act as superantigens to provoke a polyclonal T-cell expansion [ 151 , 152 ] making it conceivable that viral variants may be more or less likely to cause disease.…”

“…Although the pathogenesis of MIS-C is not well understood, it has been suggested that components of the virus may act as superantigens to provoke a polyclonal T-cell expansion [ 151 , 152 ] making it conceivable that viral variants may be more or less likely to cause disease. The available sequences suggest that MIS-C associated viruses might be drawn from several distinct lineages that are representative of circulating virus without any genetic similarities that tie them together [ 150 ]. However, it is notable that the original experience with the virus in China did not detect any MIS-C, raising the possibility that this is presentation is linked to later forms of the virus.…”

Pathophysıology of Covıd 19 Related Multisystem Inflammatory Syndrome in Children

“…Bununla birlikte, bazı çocukların PCR testi pozitiftir. Mevcut vaka serilerinde, hem PCR hem de seroloji uygulanan 783 çocuk hastanın %60'ında PCR negatif ve seroloji pozitif, %34'ünde her iki testte de pozitif ve %5'inde ise her iki testte de negatif saptanmıştır(2,6,8,10,13).MIS-C'nin Çin ve COVID-19'dan etkilenen diğer Asya ülkelerinde tanımlanmaması gerçeği, koronavirüslerdeki varyasyonlara veya bu popülasyonların artan duyarlılık veya genomik varyasyonuna ilişkin spekülasyonlara yol açmıştır(14).MIS-C'li 11 çocukta SARS-CoV-2 viral sekanslarını inceleyen bir çalışmada, MIS-C'siz akut COVID-19'lu çocuklardan alınan viral sekanslarla karşılaştırıldığında herhangi bir farklılık tespit edilmemiştir(15). Bu ön veriler, neden bazı çocukların SARS-CoV2 enfeksiyonu sonrası multi sistemik enflamasyon geliştirdiğini, diğerlerinin ise geliştirmediğini sadece viral faktörlerin açıklamadığını göstermektedir.…”