?Super antigens? tied to mysterious COVID-19 syndrome in children

A recent report from the U.S. Centers for Disease Control and Prevention analyzed coronavirus fatalities in people under 21 and found that the majority were from MIS-C.“It happens so rapidly, and the kids are so ill, that 70 percent will require admission into an ICU,” says Alvaro Moreira, a physician scientist at the University of Texas in San Antonio who recently published an analysis of results from multiple scientific papers in EClinicalMedicine based on 662 cases of MIS-C.Even as clarity emerges around the early stages of the syndrome, questions are mounting about its true prevalence and its long-term outcomes. Arditi says, “We finally found the viral spike segment that may induce all those immune responses”—not only in MIS-C but possibly in adult COVID-19 cases.A new CDC study, largely overlooked because it came out the same weekend as President Trump’s COVID-19 diagnosis, shows that even adults with the virus can develop a severe condition similar to MIS-C. The report described 27 patients with “cardiovascular, gastrointestinal, dermatologic [skin], and neurologic symptoms without severe respiratory illness,” and called the condition MIS-A—for adults.Toxic shock has also long been associated with short- and long-term mental dysfunction, so Bahar wonders if the super antigen quality of SARS-CoV-2’s spike might also explain the high percentage of neurologic symptoms seen in adult COVID-19 patients. And he cautions that we don’t know the long-term implications.“We know that patients with Kawasaki disease can later develop aneurysms, thromboses, or blood clots, and have increased risk of high blood pressure and heart attacks at a younger age,” he says.The lasting consequences of the condition may fall unequally on Black, Indigenous, and people of color: Both Moreira’s review and the CDC report on MIS-C found that, as with adults who have the virus, racial disparities were clear.