tetano
Editor, Senior Moderator
EClinicalMedicine
. 2021 Apr 15;100831.
doi: 10.1016/j.eclinm.2021.100831. Online ahead of print.
Reduced inflammatory responses to SARS-CoV-2 infection in children presenting to hospital with COVID-19 in China
Guoqing Qian[SUP] 1 2 [/SUP], Yong Zhang[SUP] 3 [/SUP], Yang Xu[SUP] 4 [/SUP], Weihua Hu[SUP] 5 [/SUP], Ian P Hall[SUP] 2 [/SUP], Jiang Yue[SUP] 6 [/SUP], Hongyun Lu[SUP] 7 [/SUP], Liemin Ruan[SUP] 8 [/SUP], Maoqing Ye[SUP] 9 [/SUP], Jin Mei[SUP] 10 [/SUP]
Affiliations
Abstract
Background: Infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in children is associated with better outcomes than in adults. The inflammatory response to COVID-19 infection in children remains poorly characterised.
Methods: We retrospectively analysed the medical records of 127 laboratory-confirmed COVID-19 patients aged 1 month to 16 years from Wuhan and Jingzhou of Hubei Province. Patients presented between January 25th and March 24th 2020. Information on clinical features, laboratory results, plasma cytokines/chemokines and lymphocyte subsets were analysed.
Findings: Children admitted to hospital with COVID-19 were more likely to be male (67.7%) and the median age was 7.3 [IQR 4.9] years. All but one patient with severe disease was aged under 2 and the majority (5/7) had significant co-morbidities. Despite 53% having viral pneumonia on computed tomography (CT) scanning only 2 patients had low lymphocyte counts and no differences were observed in the levels of plasma proinflammatory cytokines, including interleukin (IL)-2, IL-4, IL-6, tumour necrosis factor (TNF)- ?
, and interferon (IFN)- ?
between patients with mild, moderate or severe disease.
Interpretations: We observed that the immune responses of children to COVID-19 infection is significantly different from that seen in adults. Our evidence suggests that SARS-CoV-2 does not trigger a robust inflammatory response or 'cytokine storm' in children with COVID-19, and this may underlie the generally better outcomes seen in children with this disease.
. 2021 Apr 15;100831.
doi: 10.1016/j.eclinm.2021.100831. Online ahead of print.
Reduced inflammatory responses to SARS-CoV-2 infection in children presenting to hospital with COVID-19 in China
Guoqing Qian[SUP] 1 2 [/SUP], Yong Zhang[SUP] 3 [/SUP], Yang Xu[SUP] 4 [/SUP], Weihua Hu[SUP] 5 [/SUP], Ian P Hall[SUP] 2 [/SUP], Jiang Yue[SUP] 6 [/SUP], Hongyun Lu[SUP] 7 [/SUP], Liemin Ruan[SUP] 8 [/SUP], Maoqing Ye[SUP] 9 [/SUP], Jin Mei[SUP] 10 [/SUP]
Affiliations
- PMID: 33880437
- PMCID: PMC8049192
- DOI: 10.1016/j.eclinm.2021.100831
Abstract
Background: Infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in children is associated with better outcomes than in adults. The inflammatory response to COVID-19 infection in children remains poorly characterised.
Methods: We retrospectively analysed the medical records of 127 laboratory-confirmed COVID-19 patients aged 1 month to 16 years from Wuhan and Jingzhou of Hubei Province. Patients presented between January 25th and March 24th 2020. Information on clinical features, laboratory results, plasma cytokines/chemokines and lymphocyte subsets were analysed.
Findings: Children admitted to hospital with COVID-19 were more likely to be male (67.7%) and the median age was 7.3 [IQR 4.9] years. All but one patient with severe disease was aged under 2 and the majority (5/7) had significant co-morbidities. Despite 53% having viral pneumonia on computed tomography (CT) scanning only 2 patients had low lymphocyte counts and no differences were observed in the levels of plasma proinflammatory cytokines, including interleukin (IL)-2, IL-4, IL-6, tumour necrosis factor (TNF)- ?
, and interferon (IFN)- ?
between patients with mild, moderate or severe disease.
Interpretations: We observed that the immune responses of children to COVID-19 infection is significantly different from that seen in adults. Our evidence suggests that SARS-CoV-2 does not trigger a robust inflammatory response or 'cytokine storm' in children with COVID-19, and this may underlie the generally better outcomes seen in children with this disease.