Children with Post COVID-19 Multisystem Inflammatory Syndrome Display Unique Pathophysiological Metabolic Phenotypes, 2025, Lawler, Yonker, Nicholson+

[SNT Gatchaman]

Children with Post COVID-19 Multisystem Inflammatory Syndrome Display Unique Pathophysiological Metabolic Phenotypes
Nathan G. Lawler; Lael M. Yonker; Samantha Lodge; Philipp Nitschke; Maureen M. Leonard; Nicola Gray; Luke Whiley; Reika Masuda; Elaine Holmes; Julien Wist; Alessio Fasano; Jeremy K. Nicholson

SARS-CoV-2 infections in children lead to symptoms from mild respiratory illness to severe postacute sequelae of COVID-19, including multisystem inflammatory syndrome in Children (MIS-C).

We conducted a metabolic profiling of 147 children’s serum samples, including acute COVID-19 patients, MIS-C patients, and healthy controls. Using nuclear magnetic resonance spectroscopy and liquid chromatography–mass spectrometry, we measured 1101 metabolites.

The results revealed distinct metabolic profiles in acute COVID-19 and MIS-C patients, with significant alterations in lipid classes. Both conditions exhibited an elevated Apo-B100/Apo-A1 ratio and increased serum inflammatory markers. MIS-C patients showed unique disruptions, including increased triglycerides and altered lipoprotein composition.

Despite milder clinical respiratory symptoms, children’s metabolic disturbances mirrored those seen in severe adult COVID-19 patients, indicating a shared inflammatory response to SARS-CoV-2. This suggests potential long-term health impacts, underscoring the need for continued research into the metabolic consequences of COVID-19 in children.

Link | PDF (Journal of Proteome Research) [Open Access]

 

[Utsikt]

What is Multisystem Inflammatory Syndrome?

 

[SNT Gatchaman]

While most children experience mild symptoms following infection, severe illness can ensue, either in the acute infection period or weeks to months after SARS-CoV-2 exposure. Such postacute sequelae of COVID-19 (PASC) include a range of disorders, including the hyperinflammatory life-threatening illness, Multisystem Inflammatory Syndrome in Children (MIS-C) or the more indolent but debilitating chronic illness, long COVID, which develops several days to weeks after the resolution of the initial SARS-CoV-2 infection. MIS-C is recognized through persistent clinical symptoms including fever, gastrointestinal disorders, cytokine storm, myocardial dysfunction, and [cardiogenic] shock, similar to those suffering with Kawasaki disease.