Pathophysiological pathway differences in children who present with COVID-19 ARDS compared to COVID -19 induced MIS-C
Conor McCafferty, Tengyi Cai, Delphine Borgel, Dominique Lasne, Sylvain Renolleau, Meryl Vedrenne‐Cloquet, Damien Bonnet, Jemma Wu, Thiri Zaw, Atul Bhatnagar, Xiaomin Song, Suelyn Van Den Helm, Natasha Letunica, Chantal Attard, Vasiliki Karlaftis, Slavica Praporski, Vera Ignjatović, Paul Monagle
Abstract
COVID-19 has infected more than 275 million worldwide (at the beginning of 2022). Children appear less susceptible to COVID-19 and present with milder symptoms. Cases of children with COVID-19 developing clinical features of Kawasaki-disease have been described. Here we utilise Mass Spectrometry proteomics to determine the plasma proteins expressed in healthy children pre-pandemic, children with multisystem inflammatory syndrome (MIS-C) and children with COVID-19 induced ARDS. Pathway analyses were performed to determine the affected pathways. 76 proteins are differentially expressed across the groups, with 85 and 52 proteins specific to MIS-C and COVID-19 ARDS, respectively. Complement and coagulation activation are implicated in these clinical phenotypes, however there was significant contribution of FcGR and BCR activation in MIS-C and scavenging of haem and retinoid metabolism in COVID-19 ARDS. We show global proteomic differences in MIS-C and COVID-ARDS, although both show complement and coagulation dysregulation. The results contribute to our understanding of MIS-C and COVID-19 ARDS in children.