Inflammatory syndromes associated with SARS-CoV-2 infection: dysregulation of the immune response across the age spectrum
Jill E. Weatherhead, Eva H. Clark, Tiphanie P. Vogel, Robert L. Atmar, Prathit A. Kulkarni
Abstract
Coronavirus disease 2019 (COVID-19) has devastated the global community since the emergence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in late 2019. Most COVID-19 cases occur in adults, and a subset develop COVID-19-associated hyperinflammatory syndrome (1), resulting in progressive respiratory illness and multiorgan dysfunction. Progression to severe COVID-19 after SARS-CoV-2 exposure is less common in young adults and children. However, since March 2020, areas with high community SARS-CoV-2 transmission have reported increasing cases of a pediatric inflammatory syndrome that occurs weeks to months after initial asymptomatic or mild SARS-CoV-2 infection (2). The US CDC termed this condition multisystem inflammatory syndrome in children (MIS-C, also known as pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 [PIMS-TS] in Europe, where it was first recognized). Since June 2020, a similar syndrome (MIS-A) has been recognized in adults (3). The pathology of MIS-C/A and its relationship to SARS-CoV-2 infection are not yet known.