Case Report: Systemic Inflammatory Response and Fast Recovery in a Pediatric Patient With COVID-19

• Main Authors: Adam Klocperk, Zuzana Parackova, Jitka Dissou, Hana Malcova, Petr Pavlicek, Tomas Vymazal, Pavla Dolezalova, Anna Sediva
• Format: Article
• Language: English
• Published: Frontiers Media S.A. 2020-07-01
• Series: Frontiers in Immunology
• Subjects: COVID-19; SARS-CoV-2; PIMS-TS; innate immunity; hemophagocytic lymphohistiocytosis; macrophage activation syndrome
• Online Access: https://www.frontiersin.org/article/10.3389/fimmu.2020.01665/full
• ISSN: 1664-3224

We report a case of an 8-year-old girl who underwent a SARS-CoV-2 infection manifesting with atypical symptoms spearheaded by abdominal discomfort and systemic inflammation and partially mimicking hemophagocytic lymphohistiocytosis (HLH) or macrophage activation syndrome (MAS), which however did not fulfill the HLH/MAS diagnostic criteria. In this case of what has since been described as Pediatric Inflammatory Multisystem Syndrome Temporally associated with SARS-COV-2 (PIMS-TS) we documented excellent clinical response to immunosuppression with systemic corticosteroids and intravenous immunoglobulins. We show a detailed longitudinal development of neutrophil immunophenotype which suggests activation and engagement of neutrophils during PIMS-TS with compensatory contraction of the response and contra-regulation of neutrophil phenotype during recovery.