SARS-CoV-2 Polymorphisms and Multisystem Inflammatory Syndrome in Children.

Abstract

* Abbreviations: COVID-19 — : coronavirus disease 2019 MIS-C — : multisystem inflammatory syndrome in children SARS-CoV-2 — : severe acute respiratory syndrome coronavirus 2 SNP — : single-nucleotide polymorphism Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), was first identified in Wuhan, China, in December 2019. It rapidly spread across the world, and on March 11, 2020, the World Health Organization declared COVID-19 a global pandemic.1 In adults, SARS-CoV-2 can manifest as severe interstitial pneumonia and hyperinflammation, with∼3% to 5% of infections requiring admission to critical care.2,3 In contrast, severe illness and death due to SARS-CoV-2 infection in children is rare.4 However, recently, a small number of cases of shock and multisystem inflammation have been reported in children who have either tested positive for SARS-CoV-2 (by polymerase chain reaction or serology) or have had epidemiological links to it. This new syndrome, which has overlapping features of Kawasaki disease, is called multisystem inflammatory syndrome in children (MIS-C).5 The exact pathogenesis of MIS-C is as yet unknown. However, it has been suggested that part of the SARS-CoV-2 viral spike protein may resemble a superantigen that could drive the development of MIS-C and trigger … Address correspondence to Judith Breuer, MD, Research Department of Infection, Division of Infection and Immunity, University College London, Cruciform Building, Gower St, London WC1E 6BT, United Kingdom. E-mail: j.breuer{at}ucl.ac.uk