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Early immune responses and prognostic factors in children with COVID-19: a single-center retrospective analysis.
Lu, Wenjie; Yang, Li; Li, Xiong; Sun, Ming; Zhang, Aiping; Qi, Shanshan; Chen, Zhi; Zhang, Lannan; Li, Jianxin; Xiong, Hao.
  • Lu W; Department of Hematology, Wuhan Children's Hospital (Wuhan Medical Care Center for Women and Children), Tongji College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
  • Yang L; Department of Hematology, Wuhan Children's Hospital (Wuhan Medical Care Center for Women and Children), Tongji College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
  • Li X; Department of Surgery, University of Michigan School of Medicine, Ann Arbor, MI, USA.
  • Sun M; Center of Excellence for Cancer Immunology and Immunotherapy, University of Michigan Rogel Cancer Center, University of Michigan School of Medicine, Ann Arbor, MI, USA.
  • Zhang A; Department of Hematology, Wuhan Children's Hospital (Wuhan Medical Care Center for Women and Children), Tongji College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
  • Qi S; Department of Hematology, Wuhan Children's Hospital (Wuhan Medical Care Center for Women and Children), Tongji College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
  • Chen Z; Department of Hematology, Wuhan Children's Hospital (Wuhan Medical Care Center for Women and Children), Tongji College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
  • Zhang L; Department of Hematology, Wuhan Children's Hospital (Wuhan Medical Care Center for Women and Children), Tongji College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
  • Li J; Department of Hematology, Wuhan Children's Hospital (Wuhan Medical Care Center for Women and Children), Tongji College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
  • Xiong H; Department of Hematology, Wuhan Children's Hospital (Wuhan Medical Care Center for Women and Children), Tongji College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
BMC Pediatr ; 21(1): 181, 2021 04 17.
Article in English | MEDLINE | ID: covidwho-1190064
ABSTRACT

BACKGROUND:

Early diagnostic indicators and the identification of possible progression to severe or critical COVID-19 in children are unknown. To investigate the immune characteristics of early SARS-CoV-2 infection in children and possible key prognostic factors for early identification of critical COVID-19, a retrospective study including 121 children with COVID-19 was conducted. Peripheral blood lymphocyte subset counts, T cell-derived cytokine concentrations, inflammatory factor concentrations, and routine blood counts were analyzed statistically at the initial presentation.

RESULTS:

The T lymphocyte subset and natural killer cell counts decreased with increasing disease severity. Group III (critical cases) had a higher Th/Tc ratio than groups I and II (common and severe cases); group I had a higher B cell count than groups II and III. IL-6, IL-10, IFN-γ, SAA, and procalcitonin levels increased with increasing disease severity. Hemoglobin concentration, and RBC and eosinophil counts decreased with increasing disease severity. Groups II and III had significantly lower lymphocyte counts than group I. T, Th, Tc, IL-6, IL-10, RBC, and hemoglobin had relatively high contribution and area under the curve values.

CONCLUSIONS:

Decreased T, Th, Tc, RBC, hemoglobin and increased IL-6 and IL-10 in early SARS-CoV-2 infection in children are valuable indices for early diagnosis of severe disease. The significantly reduced Th and Tc cells and significantly increased IL-6, IL-10, ferritin, procalcitonin, and SAA at this stage in children with critical COVID-19 may be closely associated with the systemic cytokine storm caused by immune dysregulation.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Systemic Inflammatory Response Syndrome / COVID-19 Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male Language: English Journal: BMC Pediatr Journal subject: Pediatrics Year: 2021 Document Type: Article Affiliation country: S12887-021-02561-y

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Systemic Inflammatory Response Syndrome / COVID-19 Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male Language: English Journal: BMC Pediatr Journal subject: Pediatrics Year: 2021 Document Type: Article Affiliation country: S12887-021-02561-y