SARS-CoV-2 Antibody Titers and Severity of Multisystem Inflammatory Syndrome in Children

Ann Clin Lab Sci. 2023 May;53(3):360-365.

Abstract

Objective: Multisystem inflammatory syndrome in children (MIS-C) is a rare yet serious pathological consequence of SARS-CoV-2 infection which is reported 4-12 weeks after the onset of COVID-19 in children and adolescents. The most common hyper-inflammatory conditions mimicking the clinical presentation of MIS-C include Kawasaki disease and toxic shock syndrome. The surveillance criteria of MIS-C were recently revised by US Center for Disease Control and Prevention to improve diagnostic precision. Although previous studies have shown that SARS-CoV-2 antibody titers correlate with COVID-19 severity, their relation to MIS-C severity remains poorly understood and the aim of the study was to investigate this.

Methods: As all the MIS-C patients get a SARS-CoV-2 antibody test performed on the first day of hospitalization, here we attempted to stratify risk for adverse outcomes due to MIS-C based on the SARS-CoV-2 antibody titers.

Results: Our studies demonstrated that SARS-CoV-2 antibody titers, specifically Total (IgG/IgM/partial IgA), Nucleocapsid IgG, and Spike IgM, do not correlate with MIS-C severity assessed based on the ICU admission, inotropic support, and mechanical respiratory support requirements.

Conclusion: Therefore, it might not be appropriate to predict the clinical course of patients presenting with MISC based on quantitative serology testing.

Keywords: Antibody titers; Hyperinflammation; MIS-C; SARS-CoV-2 serology.

MeSH terms

  • Adolescent
  • Antibodies, Viral
  • COVID-19*
  • Child
  • Humans
  • Immunoglobulin G
  • Immunoglobulin M
  • SARS-CoV-2

Substances

  • Antibodies, Viral
  • Immunoglobulin G
  • Immunoglobulin M

Supplementary concepts

  • pediatric multisystem inflammatory disease, COVID-19 related