PMC9278083_01
Immunologically boosted MIS-C cases in relation to local case epidemiology. This illustration highlights study interventions and timing of presentation and immune challenge of subjects UBMISC4, UBMISC5, and UBMISC7. Age-appropriate Pfizer-BioNTech COVID-19 vaccine was used. Local county PCR confirmed cases are graphed by date for comparison. Case findings are not perfectly to scale.
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All three children highlighted in this report were originally infected in our "January 2021 peak" cluster of cases (Fig. 1).
Auricular chondritis after MIS-C. Photograph of child's normal ear (on left), taken between events, compared to the first event of recurrent auricular inflammation (on right) in Subject MISC4.
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Months later, after several insect bites, his mom noted his ears swelled and became tender and red bilaterally, consistent with auricular chondritis (Fig. 2).
Immunoglobulin G titers against SARS-CoV-2 RBD and trimerized spike. Data is from ELISA results using recombinant proteins expressed in human cell expression system. Symbols are noted in legend (black squares-adult cases, grey diamond-pediatric cases, open symbols-rechallenged pediatric cases).
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Titers, resolved by ELISA testing on Spike trimer and RBD, showed subjects with MIS-C had higher titers against RBD, consistent with many cases having resolved their acute infection (Fig. 3). Their immune response against RBD and Spike protein showed significant boosting compared to acute and/or prior sampling (Fig. 3, open symbols as noted in figure legend).
Immunoglobulin M and A titers against SARS-CoV-2 RBD and trimerized spike. Data is from ELISA results using recombinant proteins expressed in human cell expression system. Symbols are noted in legend (black squares-adult cases, grey diamond-pediatric cases, open symbols-rechallenged pediatric cases).
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As other studies have shown, IGA and IGM responses are more variable than IGG responses (Fig. 4).