{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T03:58:31Z","timestamp":1790913511536,"version":"4.1.0"},"reference-count":41,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T00:00:00Z","timestamp":1760572800000},"content-version":"vor","delay-in-days":288,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatrics International"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pediatric multisystem inflammatory syndrome temporally associated with SARS\u2010CoV\u20102 (PIMS\u2010TS) remains an enigmatic disease process, with phenotypic similarities to Kawasaki disease, although many patients present with transient cardiac dysfunction. Biomarkers help validate diagnosis, but the correlation of biomarkers to disease severity or prognosis is poorly understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>We retrospectively reviewed PIMS\u2010TS patients treated in Oxford between May 2020 and May 2022. Data on demographics, presenting features, biochemical markers, treatment, and outcomes were reviewed, and patients with\/without the need for vasoactive medications were compared.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We identified 63 patients, median age 10.3\u2009years (range 1.2\u201315.2\u2009years). Where tested, 51\/54 (94.4%) were SARS\u2010CoV\u20102\u2010antibody positive. Admissions followed regional peaks in SARS\u2010CoV\u20102 infection. Forty children (63.5%) required vasoactive medications. Amongst those requiring vasoactive medications, peak NT\u2010pro\u2010BNP (median 11,363\u2009ng\/L vs. 3741\u2009ng\/L,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004) and length of stay (median 8.4 vs. 6.4\u2009days,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.021) were greater. Vitamin D levels inversely correlated with peak CRP (spearman\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009\u22120.34,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.007) and duration of vasoactive medications (spearman\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009\u22120.34,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.030). Furthermore, low serum vitamin D correlated with lower SARS\u2010CoV\u20102 anti\u2010nucleocapsid titers (spearman\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.43,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0014). Children receiving IV methylprednisolone, 54\/63 (85.7%) (of whom, 16\/54 received IVIg and methylprednisolone) had a more rapid fall in CRP than those given IVIg alone (7\/63; 11.1%) or no immunomodulatory treatment (2\/63; 3.2%). No patients had coronary artery aneurysm or persistent cardiac sequelae at discharge.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Methylprednisolone suppressed CRP early and without evidence of coronary aneurysm in this cohort. We demonstrate a relationship between vitamin D, SARS\u2010CoV\u20102 anti\u2010nucleocapsid antibody production, inflammatory biomarkers, and duration of vasoactive medication, requiring further validation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ped.70241","type":"journal-article","created":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T10:05:47Z","timestamp":1760609147000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Vitamin D may influence disease course in\n                    <scp>PIMS<\/scp>\n                    \u2010\n                    <scp>TS<\/scp>\n                    \/\n                    <scp>MIS<\/scp>\n                    \u2010C: An observational cohort study"],"prefix":"10.1111","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9859-7383","authenticated-orcid":false,"given":"James E. G.","family":"Charlesworth","sequence":"first","affiliation":[{"name":"Department of Paediatrics Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital  Oxford UK"},{"name":"Department of Paediatrics University of Oxford, John Radcliffe Hospital  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3717-1295","authenticated-orcid":false,"given":"Joshua","family":"Navarajasegaran","sequence":"additional","affiliation":[{"name":"Acute General Medicine Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7447-5514","authenticated-orcid":false,"given":"Akhila","family":"Kavirayani","sequence":"additional","affiliation":[{"name":"Paediatric Rheumatology Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-3767-5343","authenticated-orcid":false,"given":"Avishay","family":"Sarfatti","sequence":"additional","affiliation":[{"name":"Paediatric Intensive Care Unit Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4693-5309","authenticated-orcid":false,"given":"Satish","family":"Adwani","sequence":"additional","affiliation":[{"name":"Paediatric Cardiology Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0703-9114","authenticated-orcid":false,"given":"St\u00e9phane","family":"Paulus","sequence":"additional","affiliation":[{"name":"Department of Paediatrics University of Oxford, John Radcliffe Hospital  Oxford UK"},{"name":"Paediatric Infectious Diseases Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital  Oxford UK"},{"name":"Oxford Vaccine Group University of Oxford, Churchill Hospital  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0697-1719","authenticated-orcid":false,"given":"Shelley","family":"Segal","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital  Oxford UK"},{"name":"Paediatric Infectious Diseases Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2045-6788","authenticated-orcid":false,"given":"James J.","family":"Gilchrist","sequence":"additional","affiliation":[{"name":"Department of Paediatrics University of Oxford, John Radcliffe Hospital  Oxford UK"},{"name":"Paediatric Infectious Diseases Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital  Oxford UK"},{"name":"Oxford Vaccine Group University of Oxford, Churchill Hospital  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6063-8896","authenticated-orcid":false,"given":"Dominic F.","family":"Kelly","sequence":"additional","affiliation":[{"name":"Department of Paediatrics University of Oxford, John Radcliffe Hospital  Oxford UK"},{"name":"Paediatric Infectious Diseases Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital  Oxford UK"},{"name":"Oxford Vaccine Group University of Oxford, Churchill Hospital  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0229-7509","authenticated-orcid":false,"given":"Emily A.","family":"Lees","sequence":"additional","affiliation":[{"name":"Department of Paediatrics University of Oxford, John Radcliffe Hospital  Oxford UK"},{"name":"Paediatric Infectious Diseases Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital  Oxford UK"},{"name":"Fitzwilliam College  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,16]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.10369"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2022.1034280"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.16420"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2021.01.054"},{"key":"e_1_2_9_6_1","unstructured":"Statistics OfN.Coronavirus (COVID\u201019) latest insights: Antibodies.2023. 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