Exploring Factors Influencing Changes in Incidence and Severity of Multisystem Inflammatory Syndrome in Children

Author:

Castaldo Pasquale1,d’Alanno Gabriele1,Biserni Giovanni Battista2ORCID,Moratti Mattia1ORCID,Conti Francesca3,Fabi Marianna4ORCID,Lanari Marcello4

Affiliation:

1. Specialty School of Pediatrics, Alma Mater Studiorum, University of Bologna, 40138 Bologna, Italy

2. UOC Territorial Pediatric Unit, AUSL Bologna, 40124 Bologna, Italy

3. Pediatric Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy

4. Pediatric Emergency Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy

Abstract

Multisystem inflammatory syndrome (MIS-C) is a rare condition associated with COVID-19 affecting children, characterized by severe and aberrant systemic inflammation leading to nonspecific symptoms, such as gastrointestinal, cardiac, respiratory, hematological, and neurological disorders. In the last year, we have experienced a progressive reduction in the incidence and severity of MIS-C, reflecting the worldwide trend. Thus, starting from the overall trend in the disease in different continents, we reviewed the literature, hypothesizing the potential influencing factors contributing to the reduction in cases and the severity of MIS-C, particularly the vaccination campaign, the spread of different SARS-CoV-2 variants (VOCs), and the changes in human immunological response. The decrease in the severity of MIS-C and its incidence seem to be related to a combination of different factors rather than a single cause. Maturation of an immunological memory to SARS-CoV-2 over time, the implication of mutations of key amino acids of S protein in VOCs, and the overall immune response elicited by vaccination over the loss of neutralization of vaccines to VOCs seem to play an important role in this change.

Publisher

MDPI AG

Subject

Infectious Diseases,Microbiology (medical),General Immunology and Microbiology,Molecular Biology,Immunology and Allergy

Reference88 articles.

1. (2023, January 27). CDC/CSTE Standardized Case Definition for Surveillance of Multisystem Inflammatory Syndrome in Children Associated with SARS-CoV-2 Infection. Available online: https://cdn.ymaws.com/www.cste.org/resource/resmgr/ps/ps2022/22-ID-02_MISC.pdf.

2. (2023, March 29). Multisystem Inflammatory Syndrome in Children and Adolescents with COVID-19. Available online: https://www.who.int/publications-detail-redirect/multisystem-inflammatory-syndrome-in-children-and-adolescents-with-covid-19.

3. A New Definition for Multisystem Inflammatory Syndrome in Children;Son;Pediatrics,2023

4. Multisystem Inflammatory Syndrome in U.S. Children and Adolescents;Feldstein;N. Engl. J. Med.,2020

5. The NHLBI Study on Long-TerM OUtcomes after the Multisystem Inflammatory Syndrome in Children (MUSIC): Design and Objectives;Truong;Am. Heart J.,2022

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