Evidence map›Paper›PMID 34632327›Full record

ArticleiScience2021

The immune landscape of SARS-CoV-2-associated Multisystem Inflammatory Syndrome in Children (MIS-C) from acute disease to recovery.

Eleni Syrimi, Eanna Fennell, Alex Richter, Pavle Vrljicak, Richard Stark, Sascha Ott, Paul G Murray, Eslam Al-Abadi, Ashish Chikermane, Pamela Dawson and 13 more

Open access · goldAbstract read
In one paragraph

Article in iScience, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers.

0numbers the graph read from it
0cells of the map it votes in
40citing papers in PubMed
11.3field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

40 citing papers in PubMed, 61 citations in OpenAlex.

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  7. The roles of arginases and arginine in immunity.Nature reviews. Immunology · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

23 authors at 7 institutions in 2 countries.

Eleni SyrimiInstitute of Immunology and Immunotherapy, University of Birmingham, B15 2TT Birmingham, UK.
Eanna FennellHealth Research Institute and the Bernal Institute, University of Limerick, Limerick, Ireland.
Alex RichterClinical Immunology Service, Institute of Immunology and Immunotherapy, University of Birmingham, B15 2TT Birmingham, UK.
Pavle VrljicakWarwick Medical School, University of Warwick, Coventry, UK.
Richard StarkBioinformatics Research Technology Platform, University of Warwick, Coventry, UK.
Sascha OttWarwick Medical School, University of Warwick, Coventry, UK.
Paul G MurrayInstitute of Immunology and Immunotherapy, University of Birmingham, B15 2TT Birmingham, UK.
Eslam Al-AbadiBirmingham Women's and Children's NHS Foundation Trust, Birmingham, UK.
Ashish ChikermaneBirmingham Women's and Children's NHS Foundation Trust, Birmingham, UK.
Pamela DawsonBirmingham Women's and Children's NHS Foundation Trust, Birmingham, UK.
Scott HackettHeartlands Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
Deepthi JyothishBirmingham Women's and Children's NHS Foundation Trust, Birmingham, UK.
Hari Krishnan KanthimathinathanBirmingham Women's and Children's NHS Foundation Trust, Birmingham, UK.
Sean MonaghanBirmingham Women's and Children's NHS Foundation Trust, Birmingham, UK.
Prasad NagakumarBirmingham Women's and Children's NHS Foundation Trust, Birmingham, UK.
Barnaby R ScholefieldBirmingham Women's and Children's NHS Foundation Trust, Birmingham, UK.
Steven WelchHeartlands Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
Naeem KhanClinical Immunology Service, Institute of Immunology and Immunotherapy, University of Birmingham, B15 2TT Birmingham, UK.
Sian FaustiniClinical Immunology Service, Institute of Immunology and Immunotherapy, University of Birmingham, B15 2TT Birmingham, UK.
Kate DaviesSystems Immunity Research Institute, School of Medicine, Cardiff University, Cardiff, UK.
Wioleta M ZelekSystems Immunity Research Institute, School of Medicine, Cardiff University, Cardiff, UK.
Pamela KearnsNIHR Birmingham Biomedical Research Centre and Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK.
Graham S TaylorInstitute of Immunology and Immunotherapy, University of Birmingham, B15 2TT Birmingham, UK.
Birmingham Women’s and Children’s NHS Foundation Trust · GBUniversity of Birmingham · GBUniversity of Warwick · GBCardiff University · GBUniversity Hospitals Birmingham NHS Foundation Trust · GBUniversity of Limerick · IENIHR Birmingham Biomedical Research Centre · GB

Funding

HCRW_ HF-19-1595
6 · The paper itself

Abstract

Multisystem inflammatory syndrome in children (MIS-C) is a life-threatening disease occurring several weeks after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Deep immune profiling showed acute MIS-C patients had highly activated neutrophils, classical monocytes and memory CD8+ T-cells, with increased frequencies of B-cell plasmablasts and double-negative B-cells. Post treatment samples from the same patients, taken during symptom resolution, identified recovery-associated immune features including increased monocyte CD163 levels, emergence of a new population of immature neutrophils and, in some patients, transiently increased plasma arginase. Plasma profiling identified multiple features shared by MIS-C, Kawasaki Disease and COVID-19 and that therapeutic inhibition of IL-6 may be preferable to IL-1 or TNF-α. We identified several potential mechanisms of action for IVIG, the most commonly used drug to treat MIS-C. Finally, we showed systemic complement activation with high plasma C5b-9 levels is common in MIS-C suggesting complement inhibitors could be used to treat the disease.

Indexed as

GenomicsImmune responseImmune system disorderImmunology

Identifiers

PMID34632327
PMCPMC8487319
OpenAlexW3202491089

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.