Multisystem inflammatory syndrome in children characterized by enhanced antigen-specific T-cell expression of cytokines and its reversal following recovery.

Background: Multisystem inflammatory syndrome (MIS) in children is considered to be a post-infectious complication of COVID-19. T-cell responses in children with this condition have not been well-studied.
Methods: We aimed to study the immune responses in children with MIS in comparison to children with acute COVID-19 and children with other infections. Whole blood was stimulated with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)-specific antigens and flow cytometry was performed to examine CD4 ⁺ and CD8 ⁺ T-cell responses.
Results: Children with MIS had higher frequencies of CD4 ⁺ and CD8 ⁺ T cells expressing cytokines at baseline and upon SARS-CoV-2 antigen-specific stimulation in comparison to children with COVID-19 and/or other infections. Children with COVID-19 also exhibited higher frequencies of CD4 ⁺ and CD8 ⁺ T cells expressing cytokines at baseline and upon SARS-CoV-2 antigen-specific stimulation in comparison to children with other infections. At 6-9 months following treatment and recovery, this enhanced response against SARS-CoV-2 antigens was down modulated in children with MIS.
Conclusion: Our study, therefore, provides evidence of enhanced activation of CD4 ⁺ and CD8 ⁺ T-cell responses in children with MIS and reversal following recovery.
Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
(© 2023 Pavan Kumar, Abbas, Renji, Venkataraman, Nancy, Varadarjan, Selladurai, Sangaralingam, Selvam, Thimmaiah, Natarajan, Ramasamy, Hissar, Ranganathan, Nutman and Babu.)