SARS-CoV-2–related MIS-C: A key to the viral and genetic causes of Kawasaki disease?
Authors: Sancho-Shimizu Vanessa , Brodin Petter , Cobat Aurélie , Biggs Catherine M. , Toubiana Julie , Lucas Carrie L. , Henrickson Sarah E. , Belot Alexandre ,   MIS-C@CHGE, Haddad Elie , Beland Kathie , Pujol Aurora , Schlüter Agatha , Planas-Serra Laura , Aguilera-Albesa Sergio , Valencia-Ramos Juan , Rodríguez-Palmero Agustí , Gut Marta , Rivière Jacques G. , Colobran Roger , Soler-Palacin Pere , Rodriguez-Gallego Carlos , Perez De Diego Rebeca , Flores Carlos , Alsina Laia , Blazquez-Gamero Daniel , Jordan Iolanda , Keles Sevgi , Emiroglu Melike , Akcan Ozge Metin , Alkan Gulsum , Aytekin Selma Erol , Gul Yahya , Tüter Öz Şadiye Kübra , Bozdemir Sefika Elmas , Bayhan Gulsum Iclal , Kanık-Yüksek Saliha , Parlakay Aslınur Özkaya , Gülhan Belgin , Yahşi Aysun , Kilic Ahmet Osman , Karbuz Adem , Erdeniz Emine Hafize , Özkan Esra Akyüz , Orbak Zerrin , Aydemir Şehnaz , Celik Jale Bengi , Kandemir Bahar , Aytekin Gökhan , Kapakli Hasan , Yarar Volkan , Yosunkaya Alper , Vatansev Hulya , Aytekin Caner , Torun Selda Hancerli , Nepesov Serdar , Coskuner Taner , Sözeri Betül , Demirkol Yasemin Kendir , Kasapcopur Ozgur , Yıldız Mehmet , Sevketoglu Esra , Hatipoğlu Nevin , Özçelik Tayfun , Yesilbas Osman , Gayretli Aydin Zeynep Gökçe , Sediva Anna , Klocperk Adam , Bloomfield Marketa , Meyts Isabelle , Delafontaine Selket , Haerynck Filomeen , Hoste Levi , Shahrooei Mohammad , Marque Laura , Neves João Farela , Novelli Giuseppe , Novelli Antonio , Aiuti Alessandro , Casari Giorgio , Bousfiha Amed Aziz , Almuhsen Saleh Zaid , Sobh Ali , Gagro Alenka , Bajolle Fanny , Bonnet Damien , Lebon Pierre , Lei Weite , Lee Danyel , Seeleuthner Yoann , Zhang Peng , Maglorius Majistor , Philippot Quentin , Pelham Simon , Bastard Paul , Zhang Qian , Jouanguy Emmanuelle , Puel Anne , Herberg Jethro , Kuijpers Taco W , Bellos Evangelos , Kaforou Myrsini , Menikou Stephanie , Pan-Hammarström Qiang , Hammarström Lennart , Abolhassani Hassan , Bryceson Yenan , Condino-Neto Antonio , Prando Carolina , Bando Silvia Yumi , Cavalcanti Andre , Fellay Jacques , Blanchard-Rohner Geraldine , Mansouri Davood , Mahmoudi Shima , Boyarchuk Oksana , Volokha Alla , Bondarenko Anastasiia , Stepanovskiy Yuriy , Mogensen Trine , van de Beek Diederik , Andreakos Evangelos , Papadaki Maria , Abou Tayoun Ahmad , Halwani Rabih , Al-Mulla Fahd , Franco José Luis , Lau Yu-Lung , Kwan Mike , Imai Kohsuke , Okada Satoshi , Bolze Alexandre , Butte Manish J. , Hsieh Elena , Drolet Beth A , Arkin Lisa , Itan Yuval , Maniatis Tom , Arditi Moshe , Cooper Megan , Schmitt Erica , Chakravorty Samya , Anderson Mark S. , Su Helen C. , Notarangelo Luigi D. , Tangye Stuart G. , Milner Joshua D. , Levin Michael , Abel Laurent , Bogunovic Dusan , Casanova Jean-Laurent , Zhang Shen-Ying 
Published: April 2021

Multisystem inflammatory syndrome in children (MIS-C) emerged in April 2020 in communities with high COVID-19 rates. This new condition is heterogenous but resembles Kawasaki disease (KD), a well-known but poorly understood and clinically heterogenous pediatric inflammatory condition for which weak associations have been found with a myriad of viral illnesses. Epidemiological data clearly indicate that SARS-CoV-2 is the trigger for MIS-C, which typically occurs about 1 mo after infection. These findings support the hypothesis of viral triggers for the various forms of classic KD. We further suggest that rare inborn errors of immunity (IEIs) altering the immune response to SARS-CoV-2 may underlie the pathogenesis of MIS-C in some children. The discovery of monogenic IEIs underlying MIS-C would shed light on its pathogenesis, paving the way for a new genetic approach to classic KD, revisited as a heterogeneous collection of IEIs to viruses.