期刊
BLOOD ADVANCES
卷 4, 期 23, 页码 6051-6063出版社
ELSEVIER
DOI: 10.1182/bloodadvances.2020003471
关键词
-
类别
资金
- CHOP Frontiers Program Immune Dysregulation Team
- National Institutes of Health (NIH)/National Institute of Allergy and Infectious Diseases [R01AI121250, R01AI103280, R01AI123433, R21AI144472, K08 AI136660, K08AI135091]
- NIH/National Cancer Institute [R01CA193776, X01HD100702-01, 5UG1CA233249, R01A1123538]
- Leukemia and Lymphoma Society
- Cookies for Kids Cancer
- Alex's Lemonade Stand Foundation for Childhood Cancer
- Stand UP 2 Cancer
- Team Connor Childhood Cancer Foundation
- Burroughs Wellcome Fund CAMS
- Clinical Immunology Society
- American Academy of Allergy, Asthma, and Immunology
- Agency for Healthcare Research and Quality [K12HS026393]
- Institute for Translation Medicine and Therapheutics (ITMAT) scholarship
- CHOP Gail Slap Fellowship Award
- NIH/National Institute of General Medical Sciences [T32-GM075766]
- NIH/National Institute of Diabetes and Digestive and Kidney Diseases [K23DK119463]
- NIH Training in Virology T32 Program [T32-AI-007324]
- Children's Oncology Group
Most children with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection have mild or minimal disease, with a small proportion developing severe disease or multisystem inflammatory syndrome in children (MIS-C). Complement-mediated thrombotic microangiopathy (TMA) has been associated with SARS-CoV-2 infection in adults but has not been studied in the pediatric population. We hypothesized that complement activation plays an important role in SARS-CoV-2 infection in children and sought to understand if TMA was present in these patients. We enrolled 50 hospitalized pediatric patientswith acute SARS-CoV-2 infection (n = 21, minimal coronavirus disease 2019 [COVID-19]; n = 11, severe COVID-19) or MIS-C (n = 18). As a biomarker of complement activation and TMA, soluble C5b9 (sC5b9, normal 247 ng/mL) was measured in plasma, and elevations were found in patients with minimal disease (median, 392 ng/mL; interquartile range [IQR], 244-622 ng/mL), severe disease (median, 646 ng/mL; IQR, 203-728 ng/mL), and MIS-C (median, 630 ng/mL; IQR, 359-932 ng/mL) compared with 26 healthy control subjects (median, 57 ng/mL; IQR, 9-163 ng/mL; P < .001). Higher sC5b9 levels were associated with higher serum creatinine (P = .01) but not age. Of the 19 patients for whom complete clinical criteria were available, 17 (89%) met criteria for TMA. A high proportion of tested children with SARS-CoV-2 infection had evidence of complement activation and met clinical and diagnostic criteria for TMA. Future studies are needed to determine if hospitalized childrenwith SARS-CoV-2 should be screened for TMA, if TMA-directed management is helpful, and if there are any short- or long-term clinical consequences of complement activation and endothelial damage in children with COVID-19 or MIS-C.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据