Abstract This proposal seeks to test two hypotheses regarding the Multisystem Inflammatory Syndrome (MIS-C) recently identified in children and young adults infected with SARS-CoV-2. We hypothesize that there is a spectrum of disease from severe acute disease to MIS-C. Severe Cov acute disease is associated with low interferon production, poor control of virus and a germinal center derived antibody response to the virus leading to long term immunity while MIS- C is associated with high interferon, efficient control of virus, but an extrafollicular derived antibody response with poor long term immunity. We will test this hypothesis through a genetic analysis, analysis of serum cytokines and analysis of anti-viral antibodies. We also hypothesize that plasma metabolic profile of subjects with MIS-C will predict short term cardiac dysfunction and long term cardiac damage.

Narrative This is a study of Multisystem Inflammatory Syndrome in children and young adults with Covid- 19 infection. The goal is to understand why some children get an acute disease and others MIS- C which is a delayed onset disease.