Plasma IL-17A is increased in patients with critical MIS-C and associated to in-hospital mortality
BackgroundMultisystem inflammatory syndrome in children (MIS-C) is a rare and severe post-COVID-19 complication with multiple phenotypes.ObjectivesThe aim of this study is to study inflammatory biomarkers (cytokines and oxidative stress) in critical MIS-C patients and to observe if there is associat...
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Frontiers Media S.A.
2025-01-01
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| author | Emmerson C. F. de Farias Luciana M. P. P. do Nascimento Manoel J. C. Pavão Junior Dalila C. A. Pavão Ana P. S. Pinheiro Andreza H. O. Pinheiro Marília C. B. Alves Kíssila M. M. M. Ferraro Larisse F. Q. Aires Luana G. Dias Mayara M. M. Machado Michaelle J. D. Serrão Raphaella R. Gomes Sara M. P. de Moraes Gabriela C. L. Pontes Railana D. F. P. Carvalho Cristiane T. C. Silva Carla M. A. das Neves Joyce C. L. dos Santos Adriana M. B. de Sousa Leda L. da Silva Mary L. F. M. F. de Mello Patricia B. Carvalho Renata de B. Braga Kathia de O. Harada Maria C. A. Justino Iran B. Costa Igor Brasil-Costa Marta C. Monteiro Gleice Clemente Maria Teresa Terreri |
| author_facet | Emmerson C. F. de Farias Luciana M. P. P. do Nascimento Manoel J. C. Pavão Junior Dalila C. A. Pavão Ana P. S. Pinheiro Andreza H. O. Pinheiro Marília C. B. Alves Kíssila M. M. M. Ferraro Larisse F. Q. Aires Luana G. Dias Mayara M. M. Machado Michaelle J. D. Serrão Raphaella R. Gomes Sara M. P. de Moraes Gabriela C. L. Pontes Railana D. F. P. Carvalho Cristiane T. C. Silva Carla M. A. das Neves Joyce C. L. dos Santos Adriana M. B. de Sousa Leda L. da Silva Mary L. F. M. F. de Mello Patricia B. Carvalho Renata de B. Braga Kathia de O. Harada Maria C. A. Justino Iran B. Costa Igor Brasil-Costa Marta C. Monteiro Gleice Clemente Maria Teresa Terreri |
| author_sort | Emmerson C. F. de Farias |
| collection | DOAJ |
| description | BackgroundMultisystem inflammatory syndrome in children (MIS-C) is a rare and severe post-COVID-19 complication with multiple phenotypes.ObjectivesThe 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.MethodsA 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 conclusionsA 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. |
| format | Article |
| id | doaj-art-beacdbd837ee435c990b2dfe2c64445d |
| institution | Kabale University |
| issn | 1664-3224 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Immunology |
| spelling | doaj-art-beacdbd837ee435c990b2dfe2c64445d2025-01-27T06:40:35ZengFrontiers Media S.A.Frontiers in Immunology1664-32242025-01-011510.3389/fimmu.2024.14850091485009Plasma IL-17A is increased in patients with critical MIS-C and associated to in-hospital mortalityEmmerson C. F. de Farias0Luciana M. P. P. do Nascimento1Manoel J. C. Pavão Junior2Dalila C. A. Pavão3Ana P. S. Pinheiro4Andreza H. O. Pinheiro5Marília C. B. Alves6Kíssila M. M. M. Ferraro7Larisse F. Q. Aires8Luana G. Dias9Mayara M. M. Machado10Michaelle J. D. Serrão11Raphaella R. Gomes12Sara M. P. de Moraes13Gabriela C. L. Pontes14Railana D. F. P. Carvalho15Cristiane T. C. Silva16Carla M. A. das Neves17Joyce C. L. dos Santos18Adriana M. B. de Sousa19Leda L. da Silva20Mary L. F. M. F. de Mello21Patricia B. Carvalho22Renata de B. Braga23Kathia de O. Harada24Maria C. A. Justino25Iran B. Costa26Igor Brasil-Costa27Marta C. Monteiro28Gleice Clemente29Maria Teresa Terreri30Division of Pediatric Intensive Care, Department of Pediatrics, Fundação Santa Casa de Misericórdia do Pará, Belém, BrazilDivision of Pediatric Intensive Care, Department of Pediatrics, Fundação Santa Casa de Misericórdia do Pará, Belém, BrazilDivision of Pediatric Intensive Care, Department of Pediatrics, Fundação Santa Casa de Misericórdia do Pará, Belém, BrazilDivision of Pediatric Intensive Care, Department of Pediatrics, Fundação Santa Casa de Misericórdia do Pará, Belém, BrazilDivision of Pediatric Intensive Care, Department of Pediatrics, Fundação Santa Casa de Misericórdia do Pará, Belém, BrazilDivision of Pediatric Intensive Care, Department of Pediatrics, Fundação Santa Casa de Misericórdia do Pará, Belém, BrazilDivision of Pediatric Intensive Care, Department of Pediatrics, Fundação Santa Casa de Misericórdia do Pará, Belém, BrazilDivision of Pediatric Intensive Care, Department of Pediatrics, Fundação Santa Casa de Misericórdia do Pará, Belém, BrazilDivision of Pediatric Intensive Care, Department of Pediatrics, Fundação Santa Casa de Misericórdia do Pará, Belém, BrazilDivision of Pediatric Intensive Care, Department of Pediatrics, Fundação Santa Casa de Misericórdia do Pará, Belém, BrazilDivision of Pediatric Intensive Care, Department of Pediatrics, Fundação Santa Casa de Misericórdia do Pará, Belém, BrazilDivision of Pediatric Intensive Care, Department of Pediatrics, Fundação Santa Casa de Misericórdia do Pará, Belém, BrazilDivision of Pediatric Intensive Care, Department of Pediatrics, Fundação Santa Casa de Misericórdia do Pará, Belém, BrazilDivision of Pediatric Intensive Care, Department of Pediatrics, Fundação Santa Casa de Misericórdia do Pará, Belém, BrazilDivision of Pediatric Intensive Care, Department of Pediatrics, Fundação Santa Casa de Misericórdia do Pará, Belém, BrazilDivision of Pediatric Intensive Care, Department of Pediatrics, Fundação Santa Casa de Misericórdia do Pará, Belém, BrazilDivision of Pediatric Intensive Care, Department of Pediatrics, Fundação Santa Casa de Misericórdia do Pará, Belém, BrazilDivision of Pediatric Intensive Care, Department of Pediatrics, Fundação Santa Casa de Misericórdia do Pará, Belém, BrazilDivision of Pediatric Intensive Care, Department of Pediatrics, Fundação Santa Casa de Misericórdia do Pará, Belém, BrazilDivision of Pediatric Intensive Care, Department of Pediatrics, Fundação Santa Casa de Misericórdia do Pará, Belém, BrazilDivision of Pediatric Intensive Care, Department of Pediatrics, Fundação Santa Casa de Misericórdia do Pará, Belém, BrazilDivision of Pediatric Intensive Care, Department of Pediatrics, Fundação Santa Casa de Misericórdia do Pará, Belém, BrazilDivision of Pediatric Intensive Care, Departament of Pediatrics, Fundação Hospital das Clínicas Gaspar Viana, Belém, BrazilDivision of Pediatric Intensive Care, Departament of Pediatrics, Fundação Hospital das Clínicas Gaspar Viana, Belém, BrazilDivision of Pediatric Intensive Care, Departament of Pediatrics, Fundação Hospital das Clínicas Gaspar Viana, Belém, BrazilClinical Research Unit, Health Surveillance Secretariat, Brazilian Ministry of Health, Instituto Evandro Chagas, Ananindeua, BrazilImmunology Laboratory, Virology Unit, Instituto Evandro Chagas, Ananindeua, BrazilImmunology Laboratory, Virology Unit, Instituto Evandro Chagas, Ananindeua, BrazilPharmaceutical Science Post-Graduation Program and Neuroscience and Cell Biology Graduate Program, Health Science Institute, Federal University of Pará/UFPA, Belém, BrazilDivision of Pediatric Rheumatology, Department of Pediatrics, Universidade Federal de São Paulo, São Paulo, BrazilDivision of Pediatric Rheumatology, Department of Pediatrics, Universidade Federal de São Paulo, São Paulo, BrazilBackgroundMultisystem inflammatory syndrome in children (MIS-C) is a rare and severe post-COVID-19 complication with multiple phenotypes.ObjectivesThe 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.MethodsA 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 conclusionsA 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.https://www.frontiersin.org/articles/10.3389/fimmu.2024.1485009/fullCOVID-19cytokinesmortalityoxidative stresspediatric intensive care unitpost-acute COVID-19 syndrome |
| spellingShingle | Emmerson C. F. de Farias Luciana M. P. P. do Nascimento Manoel J. C. Pavão Junior Dalila C. A. Pavão Ana P. S. Pinheiro Andreza H. O. Pinheiro Marília C. B. Alves Kíssila M. M. M. Ferraro Larisse F. Q. Aires Luana G. Dias Mayara M. M. Machado Michaelle J. D. Serrão Raphaella R. Gomes Sara M. P. de Moraes Gabriela C. L. Pontes Railana D. F. P. Carvalho Cristiane T. C. Silva Carla M. A. das Neves Joyce C. L. dos Santos Adriana M. B. de Sousa Leda L. da Silva Mary L. F. M. F. de Mello Patricia B. Carvalho Renata de B. Braga Kathia de O. Harada Maria C. A. Justino Iran B. Costa Igor Brasil-Costa Marta C. Monteiro Gleice Clemente Maria Teresa Terreri Plasma IL-17A is increased in patients with critical MIS-C and associated to in-hospital mortality Frontiers in Immunology COVID-19 cytokines mortality oxidative stress pediatric intensive care unit post-acute COVID-19 syndrome |
| title | Plasma IL-17A is increased in patients with critical MIS-C and associated to in-hospital mortality |
| title_full | Plasma IL-17A is increased in patients with critical MIS-C and associated to in-hospital mortality |
| title_fullStr | Plasma IL-17A is increased in patients with critical MIS-C and associated to in-hospital mortality |
| title_full_unstemmed | Plasma IL-17A is increased in patients with critical MIS-C and associated to in-hospital mortality |
| title_short | Plasma IL-17A is increased in patients with critical MIS-C and associated to in-hospital mortality |
| title_sort | plasma il 17a is increased in patients with critical mis c and associated to in hospital mortality |
| topic | COVID-19 cytokines mortality oxidative stress pediatric intensive care unit post-acute COVID-19 syndrome |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2024.1485009/full |
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