Monica Gelzo, Antonietta Giannattasio, Marco Maglione, Stefania Muzzica, Carolina D’Anna, Filippo Scialò, Thaililja Gagliardo, Michela Grieco, Vincenzo Tipo, Giuseppe Castaldo, Gelzo, M., Giannattasio, A., Maglione, M., Muzzica, S., D'Anna, C., Scialo, F., Gagliardo, T., Grieco, M., Tipo, V., Castaldo, G., Gelzo, Monica, Giannattasio, Antonietta, Maglione, Marco, Muzzica, Stefania, D'Anna, Carolina, Scialò, Filippo, Gagliardo, Thaililja, Grieco, Michela, Tipo, Vincenzo, and Castaldo, Giuseppe
Endothelial hyperinflammation and vasculitis are known hallmarks of acute COVID-19 and multisystem inflammatory syndrome in children (MIS-C). They are due to the direct effect of the virus on endothelial cells enhanced by pro-inflammatory modulators and may cause venous/arterial thrombosis. Therefore, it is essential to identify patients with endothelial damage early in order to establish specific therapies. We studied the monocyte chemoattractant protein 1 (MCP-1), the perinuclear anti-neutrophil cytoplasmic antibodies (pANCA), and the vascular endothelial growth factor A (VEGF-A) in serum from 45 MIS-C patients at hospital admission and 24 healthy controls (HC). For 13/45 MIS-C patients, we measured the three serum biomarkers also after one week from hospitalization. At admission, MIS-C patients had significantly higher levels of MCP-1 and VEGF-A than the HC, but no significant differences were observed for pANCA. While after one week, MCP-1 was significantly lower, pANCA was higher and VEGF-A levels were not significantly different from the admission values. These findings suggest an involvement of epithelium in MIS-C with an acute phase, showing high MCP-1 and VEGF-A, followed by an increase in pANCA that suggests a vasculitis development. The serum biomarker levels may help to drive personalized therapies in these phases with anticoagulant prophylaxis, immunomodulators, and/or anti-angiogenic drugs.