Nucleic acid biomarkers of immune response and cell and tissue damage in children with COVID-19 and MIS-C, 2023, Connor J Loy et al

Researchers identify unique biomarker patterns identifying MIS-C and severe COVID in children.

Highlights

• Patients with MIS-C( multisystem inflammatory syndrome in children)and COVID-19 have distinct cell injury and host response profiles
• Patients with MIS-C and COVID-19 have elevated solid organ derived cell-free DNA
• Patients with MIS-C have increased endothelial and neuronal derived cell-free RNA
• Cell-free and whole blood RNA provide complementary measurements of patient health

Summary
Differential host responses in coronavirus disease 2019 (COVID-19) and multisystem inflammatory syndrome in children (MIS-C) remain poorly characterized. Here we use next-generation sequencing to longitudinally analyze blood samples from pediatric patients with acute COVID-19 (n=70) or MIS-C (n=141) across three hospitals. Profiling of plasma cell-free nucleic acids uncovers distinct signatures of cell injury and death between COVID-19 and MIS-C, with increased multi-organ involvement in MIS-C encompassing diverse cell types including endothelial and neuronal cells, and an enrichment of pyroptosis related genes.

Whole blood RNA profiling reveals upregulation of similar pro-inflammatory pathways in COVID-19 and MIS-C, but also MIS-C specific downregulation of T cell-associated pathways. Profiling of plasma cell-free RNA and whole blood RNA in paired samples yields different yet complementary signatures for each disease state.

Our work provides a systems-level view of immune responses and tissue damage in COVID-19 and MIS-C and informs the future development of new disease biomarkers.

https://www.cell.com/cell-reports-medicine/fulltext/S2666-3791(23)00148-9