Children's Hospital of Los Angeles, Los Angeles, California, USA.
Mucosal Immunology and Biology Research Center, Massachusetts General Hospital, Boston, Massachusetts, USA; email:
Annu Rev Virol. 2024 Sep;11(1):327-341. doi: 10.1146/annurev-virology-093022-011839. Epub 2024 Aug 30.
The effects of SARS-CoV-2 infection on children continue to evolve following the onset of the COVID-19 pandemic. Although life-threatening multisystem inflammatory syndrome in children (MIS-C) has become rare, long-standing symptoms stemming from persistent immune activation beyond the resolution of acute SARS-CoV-2 infection contribute to major health sequelae and continue to pose an economic burden. Shared pathophysiologic mechanisms place MIS-C and long COVID within a vast spectrum of postinfectious conditions characterized by intestinal dysbiosis, increased gut permeability, and varying degrees of immune dysregulation. Insights obtained from MIS-C will help shape our understanding of the more indolent and prevalent postacute sequelae of COVID and ultimately guide efforts to improve diagnosis and management of postinfectious complications of SARS-CoV-2 infection in children.
SARS-CoV-2 感染对儿童的影响在 COVID-19 大流行开始后仍在不断演变。虽然危及生命的儿童多系统炎症综合征（MIS-C）已经变得罕见，但持续的免疫激活导致的长期症状超出了急性 SARS-CoV-2 感染的消退，这导致了主要的健康后遗症，并继续构成经济负担。共同的病理生理机制将 MIS-C 和长期 COVID 置于广泛的感染后病症谱中，其特征是肠道菌群失调、肠道通透性增加以及不同程度的免疫失调。从 MIS-C 中获得的见解将有助于我们理解更为隐匿和普遍的 COVID 急性后期后遗症，并最终指导我们努力改善儿童 SARS-CoV-2 感染的感染后并发症的诊断和管理。
