Researchers Use Advanced Technology to Detect MIS-C

By Jonathan Springston, Editor, Relias Media

A group of investigators used next-generation sequencing technology to find blood biomarkers from COVID-19 that are distinct from those of multisystem inflammatory syndrome in children (MIS-C), an inflammatory disorder that can occur weeks after SARS-CoV-2 infection.

Researchers studied samples gathered at three hospitals from 70 pediatric patients with acute COVID-19 and 141 pediatric patients with MIS-C, which can cause swelling in the brain, eyes, heart, lungs, and other organs. The authors focused on cell-free nucleic acids, specific DNA and RNA molecules in blood scientists can use to learn more about a patient’s organ health.

Using high-speed, artificial intelligence-controlled molecular sequencing, investigators discovered the blood from patients with MIS-C contained biomarkers that indicated damage to multiple organs, the lining of blood vessels, and the nervous system. Notably, this technology allowed researchers to see distinct signatures of cell injury for MIS-C and COVID-19.

“In MIS-C, we found elevated levels of cell-free RNA from neuronal cells, endothelial cells that compose arteries and veins, and a specific type of immune cell — neutrophils. This indicates that these cells are damaged in patients with MIS-C, but further validation is needed,” said Conor Loy, one of the study’s authors and a doctoral student at Cornell University. “Our hope is that these findings provide further insight into MIS-C and can lead to the development of tools to help clinicians diagnosis patients quicker.”

In the just-released May issue of Infectious Disease Alert, authors Farah G. Hassan, MBBS, and Philip R. Fischer, MD, DTM&H, wrote about the difficulty in diagnosing MIS-C. For example, Hassan and Fisher analyzed a recent study of more than 359 patients, 126 of whom received a confirmed MIS-C diagnosis, 28 of whom were diagnosed with Kawasaki disease, and 11 of whom met criteria for both. The remaining patients were considered “MIS-C mimickers.”

Exploring further, these investigators found a host of other illnesses among mimickers, including bacterial infections (e.g., febrile urinary tract infection, pneumonia, and murine typhus) and viral infections (e.g., adenovirus, rhinovirus/enterovirus, and new acute SARS-CoV-2). “When MIS-C is suspected, careful diagnostic consideration is important, and treatment can be life-saving,” Hassan and Fisher concluded. “At the same time, however, patients suspected of having MIS-C also should be carefully evaluated for the presence of both infectious and non-infectious conditions that could be contributing to their findings, and they should be appropriately treated in light of all possible diagnoses.”

For more even more on MIS-C and related subjects, be sure to read the latest issues of Hospital Infection Control & Prevention and Pediatric Emergency Medicine Reports.