SARS-CoV-2 infection and recovery in children: Distinct T cell responses in MIS-C compared to COVID-19

SARS-CoV-2 infection for most children results in mild or minimal symptoms, though in rare cases severe disease can develop, including a multisystem inflammatory syndrome (MIS-C) with myocarditis. Here, we present longitudinal profiling of immune responses during acute disease and following recovery...

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Bibliographic Details
Published in:The Journal of experimental medicine 2023-08, Vol.220 (8)
Main Authors: Rybkina, Ksenia, Bell, Joseph N, Bradley, Marissa C, Wohlbold, Teddy, Scafuro, Marika, Meng, Wenzhao, Korenberg, Rebecca C, Davis-Porada, Julia, Anderson, Brett R, Weller, Rachel J, Milner, Joshua D, Moscona, Anne, Porotto, Matteo, Luning Prak, Eline T, Pethe, Kalpana, Connors, Thomas J, Farber, Donna L
Format: Article
Language:English
Subjects:
Child
COVID-19
Humans
Infectious Disease and Host Defense
Inflammation
SARS-CoV-2
Severity of Illness Index
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Summary:SARS-CoV-2 infection for most children results in mild or minimal symptoms, though in rare cases severe disease can develop, including a multisystem inflammatory syndrome (MIS-C) with myocarditis. Here, we present longitudinal profiling of immune responses during acute disease and following recovery in children who developed MIS-C, relative to children who experienced more typical symptoms of COVID-19. T cells in acute MIS-C exhibited transient signatures of activation, inflammation, and tissue residency which correlated with cardiac disease severity, while T cells in acute COVID-19 upregulated markers of follicular helper T cells for promoting antibody production. The resultant memory immune response in recovery showed increased frequencies of virus-specific memory T cells with pro-inflammatory functions in children with prior MIS-C compared to COVID-19 while both cohorts generated comparable antibody responses. Together our results reveal distinct effector and memory T cell responses in pediatric SARS-CoV-2 infection delineated by clinical syndrome, and a potential role for tissue-derived T cells in the immune pathology of systemic disease.
ISSN:0022-1007
1540-9538
1540-9538
DOI:10.1084/jem.20221518