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Characteristics of immune and inflammatory responses among different age groups of pediatric patients with COVID-19 in China.
Ji, Su-Qiong; Zhang, Min; Zhang, Yong; Xia, Kun; Chen, Yuan; Chu, Qian; Wei, Yong-Chang; Zhou, Fu-Ling; Bu, Bi-Tao; Tu, Hong-Lei; Cao, Ya-Yun; Hu, Li-Ya.
  • Ji SQ; Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
  • Zhang M; Department of Cardiovascular Medicine, Wuhan Children' Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
  • Zhang Y; Department of Cardiovascular Medicine, Wuhan Children' Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
  • Xia K; Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
  • Chen Y; Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
  • Chu Q; Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
  • Wei YC; Department of Radiation and Medical Oncology, Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, China.
  • Zhou FL; Department of Hematology, Zhongnan Hospital of Wuhan University, Wuhan, China.
  • Bu BT; Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
  • Tu HL; Department of Hematology, Zhongnan Hospital of Wuhan University, Wuhan, China.
  • Cao YY; Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
  • Hu LY; Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. liya_hu@163.com.
World J Pediatr ; 17(4): 375-384, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1338281
ABSTRACT

BACKGROUND:

Severe cases of coronavirus disease 2019 (COVID-19) among pediatric patients are more common in children less than 1 year of age. Our aim is to address the underlying role of immunity and inflammation conditions among different age groups of pediatric patients.

METHODS:

We recruited pediatric patients confirmed of moderate COVID-19 symptoms, admitted to Wuhan Children's Hospital from January 28th to April 1st in 2020. Patients were divided into four age groups (≤ 1, 1-6, 7-10, and 11-15 years). Demographic information, clinical characteristics, laboratory results of lymphocyte subsets test, immune and inflammation related markers were all evaluated.

RESULTS:

Analysis included 217/241 (90.0%) of patients with moderate clinical stage disease. Average recovery time of children more than 6 years old was significantly shorter than of children younger than 6 years (P = 0.001). Reduced neutrophils and increased lymphocytes were significantly most observed among patients under 1 year old (P < 0.01). CD19+ B cells were the only significantly elevated immune cells, especially among patients under 1 year old (cell proportion n = 12, 30.0%, P < 0.001; cell count n = 13, 32.5%, P < 0.001). While, low levels of immune related makers, such as immunoglobulin (Ig) G (P < 0.001), IgA (P < 0.001), IgM (P < 0.001) and serum complement C3c (P < 0.001), were also mostly found among patients under 1 year old, together with elevated levels of inflammation related markers, such as tumor necrosis factor γ (P = 0.007), interleukin (IL)-10 (P = 0.011), IL-6 (P = 0.008), lactate dehydrogenase (P < 0.001), and procalcitonin (P = 0.007).

CONCLUSION:

The higher rate of severe cases and long course of COVID-19 among children under 1 year old may be due to the lower production of antibodies and serum complements of in this age group.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Systemic Inflammatory Response Syndrome / SARS-CoV-2 / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male Country/Region as subject: Asia Language: English Journal: World J Pediatr Journal subject: Pediatrics Year: 2021 Document Type: Article Affiliation country: S12519-021-00440-1

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Systemic Inflammatory Response Syndrome / SARS-CoV-2 / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male Country/Region as subject: Asia Language: English Journal: World J Pediatr Journal subject: Pediatrics Year: 2021 Document Type: Article Affiliation country: S12519-021-00440-1