A monocyte/dendritic cell molecular signature of SARS-CoV-2-related multisystem inflammatory syndrome in children with severe myocarditis

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de Cevins, Camille | Luka, Marine | Smith, Nikaïa | Meynier, Sonia | Magérus, Aude | Carbone, Francesco | García-Paredes, Víctor | Barnabei, Laura | Batignes, Maxime | Boullé, Alexandre | Stolzenberg, Marie-Claude | Pérot, Brieuc, P. | Charbit, Bruno | Fali, Tinhinane | Pirabakaran, Vithura | Sorin, Boris | Riller, Quentin | Abdessalem, Ghaith | Beretta, Maxime | Grzelak, Ludivine | Goncalves, Pedro | Di Santo, James, P. | Mouquet, Hugo | Schwartz, Olivier | Zarhrate, Mohammed | Parisot, Mélanie | Bole-Feysot, Christine | Masson, Cécile | Cagnard, Nicolas | Corneau, Aurélien | Brunaud, Camille | Zhang, Shen-Ying | Casanova, Jean-Laurent | Bader-Meunier, Brigitte | Haroche, Julien | Melki, Isabelle | Lorrot, Mathie | Oualha, Mehdi | Moulin, Florence | Bonnet, Damien | Belhadjer, Zahra | Leruez, Marianne | Allali, Slimane | Gras-Leguen, Christèle | de Pontual, Loïc | Study Group, Pediatric-Biocovid | Fischer, Alain | Duffy, Darragh | Rieux-Laucat, Fredéric | Toubiana, Julie | Ménager, Mickaël

Edité par CCSD ; Cell Press -

International audience. BackgroundSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in children is generally milder than in adults, but a proportion of cases result in hyperinflammatory conditions often including myocarditis.MethodsTo better understand these cases, we applied a multiparametric approach to the study of blood cells of 56 children hospitalized with suspicion of SARS-CoV-2 infection. Plasma cytokine and chemokine levels and blood cellular composition were measured, alongside gene expression at the bulk and single-cell levels.FindingsThe most severe forms of multisystem inflammatory syndrome in children (MIS-C) related to SARS-CoV-2 that resulted in myocarditis were characterized by elevated levels of pro-angiogenesis cytokines and several chemokines. Single-cell transcriptomics analyses identified a unique monocyte/dendritic cell gene signature that correlated with the occurrence of severe myocarditis characterized by sustained nuclear factor κB (NF-κB) activity and tumor necrosis factor alpha (TNF-α) signaling and associated with decreased gene expression of NF-κB inhibitors. We also found a weak response to type I and type II interferons, hyperinflammation, and response to oxidative stress related to increased HIF-1α and Vascular endothelial growth factor (VEGF) signaling.ConclusionsThese results provide potential for a better understanding of disease pathophysiology.

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