Discover and read the best of Twitter Threads about #MISC

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THREAD

Des chercheurs de Necker découvrent la cause du syndrome inflammatoire généralisé PIMS/MIS-C

Une perte de fonction sur les gènes OAS1, 2 et RNASEL, entraînant une réponse phagocytaire excessive.

#Covid19 #PIMS #MISC #enfants

institutimagine.org/fr/covid-19-de…
1 enfant sur 10.000. Calculez.

Le PIMS ne s'est pas arrêté grâce à "la chance" Omicron.

Tous les enfants susceptibles de le développer en sont désormais atteints. TOUS.

Bravo à Blanquer, Robert Cohen, Gras le Guen et, bien sur, Macron.

#Covid19 #PIMS #MISC #Enfants
Vous les avez tous eus !

Laisser circuler un virus mal connu. Inventer une fable expliquant qu'il contournait les - de 18 ans. Ce n'était pas une bonne idée.

70% d'hospitalisation en SI
2% de mortalité
7% développent un anévrisme coronarien

#Covid19 #PIMS #MISC #Enfants
Read 7 tweets
1/6 Interesting work from Dr. William Encinosa and colleagues, with #Black #children disproportionately affected...

#complications #adverse #drug #events #costs #disparities #multisystem #inflammatory
#syndrome #MISC #children #COVID19 #LongCovidKids

jamanetwork.com/journals/jaman…
2/6 "Did outcomes vary by the number of organ systems affected in #multisystem #inflammatory #syndrome in #children (MIS-C) in 2021?"
3/6 "In this cross-sectional study of 4107 #MISC #hospitalizations, as the number of #organ #systems affected increased from 2 to 6 or more, mortality increased from 1% to 6%, length of stay doubled from 4 to 8 days,..."
Read 6 tweets
1/ Together with the COVID Human Genetics Effort, we are happy to report our finding of inborn errors of the OAS-RNase L pathway in children with MIS-C #Misc #Pims in @ScienceMagazine (science.org/doi/10.1126/sc…)
2/ Multisystem inflammatory syndrome of children (MIS-C) is characterized by a massive inflammation about 4 weeks post benign #COVID19 upon infection by #SARSCoV2, with life-threatening cardio-vascular manifestations (nejm.org/doi/10.1056/NE…; link.springer.com/article/10.100…)
3/ A specific feature of MIS-C is the massive expansion of Vbeta21.3 CD4 and CD8 T cells in most patients (science.org/doi/10.1126/sc…, doi.org/10.1016/j.immu…, nature.com/articles/s4159…, jci.org/articles/view/…, doi.org/10.1084/jem.20…)
Read 20 tweets
"In the past month we found a 30-fold increased incidence of Kawasaki-like disease. A similar outbreak of [severe] Kawasaki-like disease is expected in countries involved in the SARS-CoV-2 epidemic"

—13 May 2020—data from Bergamo—Italy @TheLancet

#MISC

thelancet.com/journals/lance…
Some early pandemic history. This in the top @TheLancet journal from May 2020 is a first description of the severe, sometimes fatal multi-inflammatory syndrome seen in children weeks after SARS-CoV-2 infection — later known as MISC or PIMS.
"Children diagnosed after the SARS-CoV-2 epidemic began showed evidence of immune response to the virus, were older, had a higher rate of cardiac involvement, and features of MAS. The SARS-CoV-2 epidemic was associated with high incidence of a severe form of Kawasaki disease."
Read 12 tweets
Excited to share our publication in @CellRepMed highlighting #neutrophil activation in #PostCovid #MISC!

Led by @bpboribong and Tom LaSalle (@harvardmed), plus coauthors @D__Irimia, @EdlowLab and more

cell.com/cell-reports-m…

@MGH_RI @MGH_Mucosalists @ragoninstitute @MassCPR
Key points:
-even in mild Pedi COVID, neutrophils display IFN signaling

-Neutrophils in MISC show sepsis-like gene expression: high degranulation, TNF and IL-1 signaling

-Neutrophils in MISC *spontaneously* form #NETS intravascularly (can’t be good…)

(Read on…)
Key points (#2)

- in MISC, Spike enters the blood (from the zonulin-mediated leak of GI reservoirs) —> spike:antibody complexes trigger #NET formation.

-IgA Spike immune complexes are most inflammatory.

-addressing GI Spike leak will be important for treatment for #MISC
Read 3 tweets
The big impact of a disease in little kids. Characteristics & Outcomes of Multisystem Inflammatory Syndrome in the #PedsICU. Great work @kindly_kel @picudoc13 @DrKenRemy1 @RBC_PICU @MKleinBiostats @JanineZeeCheng @ColinRogerson5 @AlexRotta @caseymccluskey journals.lww.com/pccmjournal/Fu…
#MIS_C is a clinical syndrome of systemic inflammation that occurs 4–6 weeks after exposure to #SARSCoV2 affecting the heart, lungs, kidneys, brain, skin, and GI system. Review by @MontyMazer @yoncabulutmd @nina_brodsky @drsturge @RBC_PICU @DrKenRemy1 journals.lww.com/pccmjournal/pa…
In this paper, we used the @vps_llc to track trends in #MIS_C in 115 #pedsICU’s since the beginning of the pandemic, and compared outcomes over time (and by strain). Of the 145,580 children admitted to the PICU, 1,338 children (0.9%) were admitted with #MISC.
Read 9 tweets
Kinderen moeten onbezorgd opgroeien. Ben ik het ook een keer eens met #loederhart 😅. Daar houden de gelijkenissen ook op want bij onbezorgdheid hoort mijn inziens gezondheid. Nu de #vaccinatiegraad stagneert en er #vaccinatie spookverhalen en onzin rondgaan een 🧵 1/15 Image
Want er waart #desinformatie rond over de werkzaamheid van #SARSCoV2 vaccins en er worden verkeerde risico analyses gemaakt. Dat maakt dat ouders die zelf gevaccineerd zijn, toch huiverig zijn om het kroost te vaccineren. Terwijl kinderen toch net als jij mensen zijn 😉. 2/15
Omdat kinderen net mensen zijn 😎, krijgen ze hetzelfde vaccin als wij in lagere dosis. Voor 5 tot 11 jarigen is dit bij #Pfizer 1/3 en bij #Moderna 1/2. Ben jij zelf gevaccineerd? Vraag jezelf dan eens af waarom iets wat voor jou veilig is dat voor je kind niet zou zijn… 3/15
Read 21 tweets
🧵1/11 Our newest paper on the "Superantigen (SAg) hypothesis" leading to autoimmunity and neurotoxin-like motifs in post-COVID syndromes, including MIS-C and Long Covid, is now online! @ArditiMd @IvetBahar @CedarsSinai #LongCovid #MISC #SARSCoV2
frontiersin.org/articles/10.33…
2/11 This is how our journey evolved. The idea for this manuscript was based on our original discovery of a "SAg-like motif" and "neurotoxin-like" motifs in SARS-CoV-2 Spike.
BioRxiv (May 2020) biorxiv.org/content/10.110…
3/11 This research was then published in PNAS (September 2020) where we showed the potential role of this "SAg-like motif" not only in MIS-C, but also in adults patients with severe COVID.
pnas.org/doi/full/10.10…
Read 11 tweets
Es allerbergert gewaltig aus Rauch.

Aber der unsägliche Grippe Vergleich von Wolf hat auch nicht sein müssen.

Duell der Verharmloser.

Keine Sternstunde der Zib2. Image
Ernsthaft, eine so massive Verleugnung von Fakten hab ich zuletzt bei servustv Protagonisten gesehen. Es ist nicht nur die ÖVP Schuld. Faßmann zufolge hatten ÖVP und Grün ein gutes Einvernehmen in der Bildungspolitik bezüglich COVID Maßnahmen.
Der ganze Baumschwurbel von Faßmann-Berater Strolz geht mit Eieruhren-Bildungssprecherin Hamann Hand in Hand.

Gleicher Esoterikbeef.

Read 6 tweets
1) How I cured my #LongCovid in 3mos after suffering for almost a year. This was my last hope. I researched what #Covid does to the body, came up with a list of "clinically studied" supplements and...
2) took them all. Firstly, I am not a MD. In March 2021 I caught Covid while working as a #frontline #healthcare worker. My symptoms of #brainfog, #fatigue, #jointpain, #muscleweakness, morning #stiffness happened after my recovery. At the time, this #postcovid #syndrome was...
3) was just starting to be discussed online. The the term #Longhauler was coined. Those in the #ME, #CFS, #Lyme #MCAS #community starting speaking out about the similarity of #symptoms with #LC. #Covidclinics started to sprout up, include one at the....
Read 48 tweets
Yep, and I ask myself when exactly it has started that people like me are considered as "the other extreme" compared with the Covid deniers whereas the scientists representing the "golden center" with a tolerable (?) burden of disease are completely neglecting longcovid.
Yesterday, I asked the provocative question how many additional deaths we will tolerate when living with Covid.
The answers clearly showed: Zero. But zero is not a choice we're given to make. Pretending to be "amidst the extremes" means >> zero.

Either way, allowing for a low number of deaths or a fairly low number of longterm disease means to implement long-lasting protective measures. The belief to control the pandemic by "living as if the pandemic were over" and causing only a low number of deaths, is wrong.
Read 9 tweets
Erst mochte ich nicht wenn die #Maskenableger , #Verharmloser & #Durchseuchungsbefürworter meinten, man würde die #Maske ja nur aus #Angst weiter tragen!

Ok ihr Liebeleins von und an #Maskenableger , #Verharmloser & #Durchseuchungsbefürworter ... Meine 'Angst' funktioniert!
Mein Schutz- & Überlebensmechanismus arbeitet einwandfrei!

Und während ich dann in 2-3 Jahren, wenn der #Coronavirus #SARSCoV2 besser erforscht wurde, es ausgereifte Behandlungsmöglichkeiten gibt und Medikamente, besser wirksame Impfstoffe auf dem Markt sind, dann werde ich ganz
frei von Angst, aber mit #Maske , mein Leben in vollsten Zügen genießen können.

Während ihr, #Maskenableger , #Verharmloser & #Durchseuchungsbefürworter , nun ja, wie formuliere ich es diplomatisch; eure #Freiheit nicht mehr genießen könnt, weil ihr in irgendeiner Art und Weise
Read 7 tweets
Acute hepatitis in kids. We urge colleagues with access to samples (blood/liver tissue) to consider SARS-CoV-2 superantigen-mediated disease, potentiated by a second virus (AdV) 🧵1/ thelancet.com/journals/langa…
2/ @ArditiMd and colleagues first described a superantigen motif in SARS-CoV-2 and several groups have independently found T-cell skewing (TRBV11-2 expanded) in kids w #MISC, indicative of a superantigen-mediated inflammation. Image
3/ Multiple reports have reported intestinal SARS-CoV-2 persistence and leakage of superantigens into the bloodstream trigger immune activation and possibly MIS-C in susceptible individuals, @LaelYonker et al Image
Read 7 tweets
La incidencia del #MISC fue de 1 por cada 3.400 personas no vacunadas con la variante delta.

La eficacia estimada de la vacuna contra el MIS-C inducido por delta fue del 94% en personas de 5-17 años.

Nuevo estudio poblacional de Dinamarca.
"Sugerimos que la efectividad de la vacuna contra MIS-C se debió a una alta protección de la vacuna contra la infección con la variante delta y posiblemente a un efecto directo de la vacuna sobre el riesgo de desarrollar MIS-C después de una infección postvacunación".
"El estudio agrega conocimiento importante sobre la incidencia del MIS-C en función de la variante de la infección anterior por SARS-CoV-2 y hasta qué punto el MIS-C es una enfermedad prevenible por vacunación".
Read 4 tweets
Let's talk about the mystery epidemic of #hepatitis in children. It's most likely a complication of #COVID19 but may take a while to be adjudicated as such. The syndrome has been seen in children <17, mostly unvaccinated kids <5 years. A thread.
Hepatitis is a known presentation of #MISC onlinelibrary.wiley.com/doi/10.1111/ij… & MISC is a late complication, after the acute infection. So, the fact that PCR is negative is not surprising.
Also, kids do not have as robust an antibody response as adults so may be -ve on serology too. nature.com/articles/s4159…
Read 12 tweets
Jetzt stellen wir uns mal vor, @jokoundklaas gewinnen gegen @Pro7 und nutzen ihre Sendezeit für das Thema #LongCovid , #longcovidkids , #pims / #misc , #MECFS ...😱🤗❤
Oder anstatt #Neidoo Sendezeit zu geben, schenken @ardmoma , @ARDde , @ZDFheute , @ZDF , @tagesschau , @WDR , @ndr usw dem Thema #LongCovid, #longcovidkids, #pims, #MECFS, #misc, #postcovid Sendezeit.

Haben die nicht auch sowas wie einen Bildungsauftrag? Frage für eine Freundin
Welche Sender sollten eurer Meinung nach den Themen #LongCovid , #PostCovid , #LongCovidkids , #pims , #misc , #MECFS , etc mehr Aufmerksamkeit und somit Sendezeit schenken? Welche Fachleute würdet ihr gerne dazu hören? Postet mal bitte hier drunter ⬇️

1000 Dank ❤
Read 3 tweets
BONNE NOUVELLE

Bilan #PIMS #Covid #Enfant du 31/03/22

Pourquoi @SantePubliqueFr ne veut pas conclure sur l’évidence d’une bonne nouvelle ?!

Omicron ne fait quasi pas de Pims mais ils ne veulent pas le dire..

1/4

santepubliquefrance.fr/content/downlo… Image
"le pic des PIMS est survenu une semaine avant le pic des hospits et la décroissance semble.. suivre celle des hospits.

=> Ce constat permet de supposer un IMPACT DIFFERENT DU VARIANT OMICRON.. sur l’épidémiologie des PIMS"
2/4 ImageImage
Le 17/02/22, SPF constate que la vague de Pims vient "essentiellement" de la vague Delta. Cette affirmation concerne la semaine 6.
Après la semaine 7, ça baisse fortement.

Il n’y a donc pas de vague de PIMS concernant OMICRON.
3/4

santepubliquefrance.fr/content/downlo… Image
Read 6 tweets
inews.co.uk/news/doctors-m…
"James was six when he had PIMS. He was misdiagnosed twice at a local hospital and eventually treated in intensive care at St Mary's, Paddington.
...
The rare post Covid condition is sometimes missed multiple times by medics"
"parents fear the situation will get worse with the end of free coronavirus testing."

PIMS – Paediatric Inflammatory Multisystem Syndrome
"PIMS is caused by the immune system which fights off the virus but then over-reacts to affect other parts of the body."
"prompt diagnosis and treatment are essential for best outcomes with PIMS, as delays can lead to life changing heart and organ damage and sometimes death. Diagnosis is challenging, however"
Read 32 tweets
#LongCovidKids in Italy || Starting from the key clinical experience of a post covid clinic in Rome

@surf4children et al

"Long-term outcomes of pediatric infections: from traditional infectious diseases to #LongCovid" | Future Microbiology
futuremedicine.com/doi/10.2217/fm…
#LongCovidKids in New Zealand 🇳🇿
A blog review of prolonged disease and sequelae in children after SARS-CoV-2 infection || including Long Covid and MIS-C || literature review and risk assessment with omicron

@DrAnnaNZ et al

@LongCovidNZ

blogs.otago.ac.nz/pubhealthexper…
Persistent lung dysfunction in children after SARS-CoV-2 infection

Even children are at risk of pulmonary sequelae from covid, despite this risk being downplayed since the early pandemic

#LongCovidKids

[pre-print]

medrxiv.org/content/10.110…
Read 14 tweets
In the last month, 420 children in the United States developed multisystem inflammatory syndrome due to COVID and 4 died. Vaccination is 91% effective in preventing #MISC. #KidsLivingWithCovid
Kids with #MISC are sick and require ICU hospitalization, often with blood pressure support medicine, steroids, blood thinners, and sometimes life support. Vaccines are 91% effective against MISC. #KidsLivingWithCovid
20.1 million children in the U.S. are fully vaccinated
💉6.2 million ages 5-11 (22%)
💉13.9 million ages 12- 17 (55%) aap.org/en/pages/2019-…
Read 6 tweets
Achtjähriges Mädchen, Mutter spricht kein Deutsch eigentlich wegen zweijähriger Schwester mit Erbrechen in der Praxis die achtjährige habe auch Bauchschmerzen und Fieber, die 12 jährige andere Schwester übersetzt. Die achtjährige sitzt stumm da es geht ihr sehr schlecht.
irgendwann fällt mir das auf, daß es eigentlich um die achtjährige geht. Fieber seit sieben Tagen Corona Anamnese wahrscheinlich im November Mutter und Tochter positiv. Aktuell kein Fieber aber starke Bauchschmerzen mit Abwehrspannung CRP Größe 150 mg/dl.
Leukozyten dagegen nur 13.000 pro Milliliter. Verlegung ins Krankenhaus: akutes Abdomen, Verdacht auf Sepsis DD #MISC Im Krankenhaus Intensivstation weil nackensteif: LP opb. freie Flüssigkeit im Bauch: Notlaparotomie ohne Ergebnis. Bei Troponin positiv etwas Perikarderguss
Read 4 tweets
I felt terribly sick on Saturday. Sore throat, flu symptoms, heavy head. My rapid test is negative. All my friends have #COVID19. Literally everyone. 349 cases in my kids school last week.Overcrowded and zero #ventilation. Sick teachers & sick kids. @ScholaEuropaea @JHahnEU
1/
On Sunday the Far right of 🇪🇺 comes to Brussels to create appalling chaos. The unspeakable violence...the politicians scape goating others... It's a lawless crowd & they don't hear our prayers. 2/
Belgian 🇧🇪Twitter Pandemic experts fight over CST: vaccine obligations. Yeah, in this first world, this is the drama. My right to not wear a face covering or take a vaccine. Not about the health consequences of the children & vulnerable. 😥 3/
Read 21 tweets
#omtadvies over 🏥 en IC-opnames: in modellen nu wel passendere aannames over #omikron en #booster:
- 40-60% minder kans 🏥
- ligduur 5 ipv 7-8 dagen
- kans IC na 🏥opname 10% ipv 16-21%
- korter serieel interval 3,5 ipv 4 dagen
- booster 90% >60 jaar, 73% >18 jaar

1/
Avondlockdown leidt dan tot een piekbezetting rondom tot net boven de deltapiek begin december 2021:
- 550-600 opnames per dag met een bedbezetting van 4000-4500
- 60-70 IC opnames per dag met een IC-bezetting van 700-800

2/
Maar:
- grote mate van onzekerheid: kan ook boven de bezetting van de deltapiek uitkomen
- effect versoepelen quarantaine kinderen niet meegenomen
- gaat uit van sluiting 17 uur (niet 22 uur en overdracht bepaald door aantal contacten maar ook door duur en intensiteit)

3/
Read 8 tweets
56 children are admitted to South Carolina Children’s Hospitals with COVID19. 55 are unvaccinated. 30 are too young to receive the vaccine. 8 are in intensive care and 2 children too young to receive the vaccine are on life support.
Source: @SC_AAP
Read 7 tweets

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