Coronavirus disease 2019 (COVID-19) has caused mild illness in children, until the emergence of the novel hyperinflammatory condition paediatric inflammatory multisystem syndrome temporally associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (PIMS-TS). PIMS-TS is thought to be a post-SARS-CoV-2 immune dysregulation with excessive inflammatory cytokine release. We studied 25 hydroxyvitamin D (25OHD) concentrations in children with PIMS-TS, admitted to a tertiary paediatric hospital in the UK, due to its postulated role in cytokine regulation and immune response. Eighteen children (median (range) age 8·9 (0·3-14·6) years, male = 10) met the case definition. The majority were of Black, Asian and Minority Ethnic (BAME) origin (89 %, 16/18). Positive SARS-CoV-2 IgG antibodies were present in 94 % (17/18) and RNA by PCR in 6 % (1/18). Seventy-eight percentage of the cohort were vitamin D deficient (< 30 nmol/l). The mean 25OHD concentration was significantly lower when compared with the population mean from the 2015/16 National Diet and Nutrition Survey (children aged 4–10 years) (24 v . 54 nmol/l (95 % CI −38·6, −19·7); P < 0·001). The paediatric intensive care unit (PICU) group had lower mean 25OHD concentrations compared with the non-PICU group, but this was not statistically significant (19·5 v . 31·9 nmol/l; P = 0·11). The higher susceptibility of BAME children to PIMS-TS and also vitamin D deficiency merits contemplation. Whilst any link between vitamin D deficiency and the severity of COVID-19 and related conditions including PIMS-TS requires further evidence, public health measures to improve vitamin D status of the UK BAME population have been long overdue.
【저자키워드】 severe acute respiratory syndrome coronavirus 2, Coronavirus disease 2019, multisystem inflammatory syndrome in children, vitamin D deficiency, Paediatric inflammatory multisystem syndrome temporally associated with severe acute respiratory syndrome coronavirus 2, Paediatric intensive care unit, 【초록키워드】 COVID-19, SARS-CoV-2, coronavirus, immune response, Bame, intensive care, survey, children, diet, susceptibility, nutrition, hospital, cytokine, RNA, Cohort, PCR, severity of COVID-19, SARS-CoV-2 IgG antibody, male, age, Inflammatory cytokine, Vitamin D status, Evidence, Concentration, Inflammatory, immune dysregulation, public health measure, Asian, deficiency, black, acute respiratory syndrome, Regulation, syndrome, 25OHD, mild illness, significantly lower, Hyperinflammatory, 95 % CI, IMPROVE, thought, caused, median, condition, majority, statistically significant, 【제목키워드】 coronavirus, Vitamin D, children, Inflammatory, acute respiratory syndrome, syndrome,