tetano
Editor, Senior Moderator
Front Immunol
. 2025 Jan 27:15:1485009.
doi: 10.3389/fimmu.2024.1485009. eCollection 2024. Plasma IL-17A is increased in patients with critical MIS-C and associated to in-hospital mortality
Emmerson C F de Farias[SUP] 1 [/SUP], Luciana M P P do Nascimento[SUP] 1 [/SUP], Manoel J C Pavão Junior[SUP] 1 [/SUP], Dalila C A Pavão[SUP] 1 [/SUP], Ana P S Pinheiro[SUP] 1 [/SUP], Andreza H O Pinheiro[SUP] 1 [/SUP], Marília C B Alves[SUP] 1 [/SUP], Kíssila M M M Ferraro[SUP] 1 [/SUP], Larisse F Q Aires[SUP] 1 [/SUP], Luana G Dias[SUP] 1 [/SUP], Mayara M M Machado[SUP] 1 [/SUP], Michaelle J D Serrão[SUP] 1 [/SUP], Raphaella R Gomes[SUP] 1 [/SUP], Sara M P de Moraes[SUP] 1 [/SUP], Gabriela C L Pontes[SUP] 1 [/SUP], Railana D F P Carvalho[SUP] 1 [/SUP], Cristiane T C Silva[SUP] 1 [/SUP], Carla M A das Neves[SUP] 1 [/SUP], Joyce C L Dos Santos[SUP] 1 [/SUP], Adriana M B de Sousa[SUP] 1 [/SUP], Leda L da Silva[SUP] 1 [/SUP], Mary L F M F de Mello[SUP] 1 [/SUP], Patricia B Carvalho[SUP] 2 [/SUP], Renata de B Braga[SUP] 2 [/SUP], Kathia de O Harada[SUP] 2 [/SUP], Maria C A Justino[SUP] 3 [/SUP], Iran B Costa[SUP] 4 [/SUP], Igor Brasil-Costa[SUP] #[/SUP][SUP] 4 [/SUP], Marta C Monteiro[SUP] #[/SUP][SUP] 5 [/SUP], Gleice Clemente[SUP] #[/SUP][SUP] 6 [/SUP], Maria Teresa Terreri[SUP] #[/SUP][SUP] 6 [/SUP]
Affiliations
Background: Multisystem inflammatory syndrome in children (MIS-C) is a rare and severe post-COVID-19 complication with multiple phenotypes.
Objectives: The aim of this study is to study inflammatory biomarkers (cytokines and oxidative stress) in critical MIS-C patients and to observe if there is association between these biomarkers and mortality.
Methods: A single-center prospective study enrolled patients with MIS-C (with positive molecular test), aged between 1 month and 18 years of age. Data was collected from 20 pediatric intensive care unit (PICU)'s bed. Inflammatory biomarkers (cytokines and oxidative stress markers) were performed on day 1 and 3 after hospitalization. Survival rate was calculated, and Kaplan-Meier curves were plotted. Univariate and multivariate Cox regression analyses were conducted. The ROC (Receiver Operating Characteristic) curve analysis was performed.
Results and conclusions: A total of 41 patients out of 109 patients admitted at PICU with suspected MIS-C during the study period were included, of which 33 (80.5%) were male, 9 (22%) were under one year old, and 30 (73.2%) presented comorbidities. Among them, 16 (39%) did not survive. The mean survival time was shorter in patients with higher levels of IL-17A (≥ 19.71 pg/mL) on day 1 (115 vs 323 days, p = 0.004). Higher levels of IL-17A on day 1 were associated with mortality in both the crude model (HR 1.03, CI95% 1.004-1.057, p = 0.022) and the adjusted model (HR 1.043, CI95% 1.013-1.075, p = 0.012). ROC analysis revealed a cut-off value for the IL-17A of 14.32 pg/ml. The other immunological and inflammatory markers did not demonstrate an association with survival (p>0.05). Our findings suggest that patients with high levels of IL-17A are at greater risk for death.
Keywords: COVID-19; cytokines; mortality; oxidative stress; pediatric intensive care unit; post-acute COVID-19 syndrome.
. 2025 Jan 27:15:1485009.
doi: 10.3389/fimmu.2024.1485009. eCollection 2024. Plasma IL-17A is increased in patients with critical MIS-C and associated to in-hospital mortality
Emmerson C F de Farias[SUP] 1 [/SUP], Luciana M P P do Nascimento[SUP] 1 [/SUP], Manoel J C Pavão Junior[SUP] 1 [/SUP], Dalila C A Pavão[SUP] 1 [/SUP], Ana P S Pinheiro[SUP] 1 [/SUP], Andreza H O Pinheiro[SUP] 1 [/SUP], Marília C B Alves[SUP] 1 [/SUP], Kíssila M M M Ferraro[SUP] 1 [/SUP], Larisse F Q Aires[SUP] 1 [/SUP], Luana G Dias[SUP] 1 [/SUP], Mayara M M Machado[SUP] 1 [/SUP], Michaelle J D Serrão[SUP] 1 [/SUP], Raphaella R Gomes[SUP] 1 [/SUP], Sara M P de Moraes[SUP] 1 [/SUP], Gabriela C L Pontes[SUP] 1 [/SUP], Railana D F P Carvalho[SUP] 1 [/SUP], Cristiane T C Silva[SUP] 1 [/SUP], Carla M A das Neves[SUP] 1 [/SUP], Joyce C L Dos Santos[SUP] 1 [/SUP], Adriana M B de Sousa[SUP] 1 [/SUP], Leda L da Silva[SUP] 1 [/SUP], Mary L F M F de Mello[SUP] 1 [/SUP], Patricia B Carvalho[SUP] 2 [/SUP], Renata de B Braga[SUP] 2 [/SUP], Kathia de O Harada[SUP] 2 [/SUP], Maria C A Justino[SUP] 3 [/SUP], Iran B Costa[SUP] 4 [/SUP], Igor Brasil-Costa[SUP] #[/SUP][SUP] 4 [/SUP], Marta C Monteiro[SUP] #[/SUP][SUP] 5 [/SUP], Gleice Clemente[SUP] #[/SUP][SUP] 6 [/SUP], Maria Teresa Terreri[SUP] #[/SUP][SUP] 6 [/SUP]
Affiliations
- PMID: 39931580
- PMCID: PMC11807959
- DOI: 10.3389/fimmu.2024.1485009
Background: Multisystem inflammatory syndrome in children (MIS-C) is a rare and severe post-COVID-19 complication with multiple phenotypes.
Objectives: The aim of this study is to study inflammatory biomarkers (cytokines and oxidative stress) in critical MIS-C patients and to observe if there is association between these biomarkers and mortality.
Methods: A single-center prospective study enrolled patients with MIS-C (with positive molecular test), aged between 1 month and 18 years of age. Data was collected from 20 pediatric intensive care unit (PICU)'s bed. Inflammatory biomarkers (cytokines and oxidative stress markers) were performed on day 1 and 3 after hospitalization. Survival rate was calculated, and Kaplan-Meier curves were plotted. Univariate and multivariate Cox regression analyses were conducted. The ROC (Receiver Operating Characteristic) curve analysis was performed.
Results and conclusions: A total of 41 patients out of 109 patients admitted at PICU with suspected MIS-C during the study period were included, of which 33 (80.5%) were male, 9 (22%) were under one year old, and 30 (73.2%) presented comorbidities. Among them, 16 (39%) did not survive. The mean survival time was shorter in patients with higher levels of IL-17A (≥ 19.71 pg/mL) on day 1 (115 vs 323 days, p = 0.004). Higher levels of IL-17A on day 1 were associated with mortality in both the crude model (HR 1.03, CI95% 1.004-1.057, p = 0.022) and the adjusted model (HR 1.043, CI95% 1.013-1.075, p = 0.012). ROC analysis revealed a cut-off value for the IL-17A of 14.32 pg/ml. The other immunological and inflammatory markers did not demonstrate an association with survival (p>0.05). Our findings suggest that patients with high levels of IL-17A are at greater risk for death.
Keywords: COVID-19; cytokines; mortality; oxidative stress; pediatric intensive care unit; post-acute COVID-19 syndrome.