Carzaniga Thomas, Calcaterra Valeria, Casiraghi Luca, Inzani Tommaso, Carelli Stephana, Del Castillo Gabriele, Cereda Danilo, Zuccotti Gianvincenzo, Buscaglia Marco
Department of Medical Biotechnology and Translational Medicine, University of Milan, Segrate, 20054, Italy.
Department of Pediatrics, Buzzi Children's Hospital, Milano, 20154, Italy.
Eur J Pediatr. 2025 May 7;184(6):327. doi: 10.1007/s00431-025-06153-1.
Multisystem Inflammatory Syndrome in Children (MIS-C) is a serious condition associated with SARS-CoV-2 infection. The relationship between SARS-CoV-2 variants of concern (VOCs) and the occurrence and severity of MIS-C is unknown. We analyzed the dynamics of MIS-C in the Milan metropolitan area (Italy) during the COVID-19 pandemic, focusing on the epidemiologic trends and disease severity in relation to different VOCs in a single-center study. Fifty-seven MIS-C patients (mean 8.3 ± 3.8 years) admitted to the Pediatric Department of Buzzi Children's Hospital in Milan, Italy, between November 2020 and July 2022, were retrospectively included in the study. The SARS-CoV-2 variant was retrospectively identified from serological fingerprinting (profiles of serum antibodies targeting different variants of SARS-CoV-2 obtained by a label-free microarray biosensor) or by the variant of prevalence. Two main periods of MIS-C case accumulation were observed. The peak of MIS-C cases rate in December 2020 reached 0.6 cases per day, which is nearly double the rate observed in February 2022, despite the larger number of infected subjects. Although the WT variant exhibited a broader range of severity score values, the score distributions for the different variants do not show statistically relevant differences.
The results clearly show a decrease in the incidence of MIS-C in relation to infections, but also support the concept that severity of MIS-C remained essentially unchanged across different virus variants, including Omicron. The course of MIS-C, once initiated, is independent from the characteristics of the triggering variants, although later variants may be considered less likely to induce MIS-C.
• MIS-C is a rare systemic inflammatory disorder that arises as a post-infectious complication temporally related to SARS-CoV-2 infection. • Fluctuations in MIS-C incidence were observed throughout the pandemic, with the latest variants associated with a lower incidence.
• The SARS-CoV-2 variant of infection can be retrospectively confirmed by serum antibody fingerprinting using a label-free microarray biosensor. • Despite the decreasing incidence, MIS-C severity has remained essentially unchanged across SARS-CoV-2 variants.
儿童多系统炎症综合征（MIS-C）是一种与严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染相关的严重病症。值得关注的SARS-CoV-2变异株（VOCs）与MIS-C的发生及严重程度之间的关系尚不清楚。我们在一项单中心研究中分析了意大利米兰都会区在2019冠状病毒病大流行期间MIS-C的动态变化，重点关注与不同VOCs相关的流行病学趋势和疾病严重程度。回顾性纳入了2020年11月至2022年7月期间在意大利米兰布齐儿童医院儿科住院的57例MIS-C患者（平均年龄8.3±3.8岁）。通过血清学指纹图谱（利用无标记微阵列生物传感器获得的针对不同SARS-CoV-2变异株的血清抗体谱）或流行变异株回顾性鉴定SARS-CoV-2变异株。观察到MIS-C病例积累的两个主要时期。2020年12月MIS-C病例率峰值达到每天0.6例，尽管感染人数更多，但这一数字几乎是2022年2月观察到的病例率的两倍。尽管野生型变异株表现出更广泛的严重程度评分值范围，但不同变异株的评分分布没有显示出统计学上的显著差异。
结果清楚地表明MIS-C发病率相对于感染有所下降，但也支持了这样一种观点，即MIS-C的严重程度在包括奥密克戎在内的不同病毒变异株中基本保持不变。MIS-C一旦发病，其病程与引发变异株的特征无关，尽管后来的变异株可能被认为诱发MIS-C的可能性较小。
•MIS-C是一种罕见的全身性炎症性疾病，是与SARS-CoV-2感染在时间上相关的感染后并发症。•在整个大流行期间观察到MIS-C发病率的波动，最新变异株与较低的发病率相关。
•感染的SARS-CoV-2变异株可通过使用无标记微阵列生物传感器的血清抗体指纹图谱进行回顾性确认。•尽管发病率下降，但MIS-C的严重程度在SARS-CoV-2变异株中基本保持不变。
