tetano
Editor, Senior Moderator
Pediatr Infect Dis J. 2020 May 1. doi: 10.1097/INF.0000000000002720. [Epub ahead of print]
A Typical Case of Critically Ill Infant of Coronavirus Disease 2019 With Persistent Reduction of T Lymphocytes.
Qiu L[SUP]1[/SUP], Jiao R[SUP]2[/SUP], Zhang A[SUP]2[/SUP], Chen X[SUP]2[/SUP], Ning Q[SUP]3[/SUP], Fang F[SUP]1[/SUP], Zeng F[SUP]2[/SUP], Tian N[SUP]2[/SUP], Zhang Y[SUP]4[/SUP], Huang Y[SUP]5[/SUP], Sun Z[SUP]6[/SUP], Dhuromsingh M[SUP]7[/SUP], Li H[SUP]8[/SUP], Li Y[SUP]9[/SUP], Xu R[SUP]1[/SUP], Chen Y[SUP]1[/SUP], Luo X[SUP]1[/SUP].
Author information
Abstract
BACKGROUND:
The outbreak of coronavirus disease 2019 (COVID-19) is becoming a global threat. However, our understanding of the clinical characteristics and treatment of critically ill pediatric patients and their ability of transmitting the coronavirus that causes COVID-19 still remains inadequate because only a handful pediatric cases of COVID-19 have been reported.
METHODS:
Epidemiology, clinical characteristics, treatment, laboratory data and follow-up information and the treatment of critically ill infant were recorded.
RESULTS:
The infant had life-threatening clinical features including high fever, septic shock, recurrent apnea, petechiae and acute kidney injury and persistent declined CD3+, CD4+ and CD8+ T cells. The duration of nasopharyngeal virus shedding lasted for 49 days even with the administration of lopinavir/ritonavir for 8 days. The CD3+, CD4+ and CD8+ T cells was partially recovered 68 days post onset of the disease. Accumulating of effector memory CD4+ T cells (CD4+TEM) was observed among T-cell compartment. The nucleic acid tests and serum antibody for the severe acute respiratory syndrome coronavirus 2 of the infant's mother who kept intimate contact with the infant were negative despite no strict personal protection.
CONCLUSIONS:
The persistent reduction of CD4+ and CD8+ T cells was the typical feature of critically ill infant with COVID-19. CD4+ and CD8+ T cells might play a key role in aggravating COVID-19 and predicts a more critical course in children. The prolonged nasopharyngeal virus shedding was related with the severity of respiratory injury. The transmission of SARS-CoV-2 from infant (even very critical cases) to adult might be unlikely.
PMID:32379199DOI:10.1097/INF.0000000000002720
A Typical Case of Critically Ill Infant of Coronavirus Disease 2019 With Persistent Reduction of T Lymphocytes.
Qiu L[SUP]1[/SUP], Jiao R[SUP]2[/SUP], Zhang A[SUP]2[/SUP], Chen X[SUP]2[/SUP], Ning Q[SUP]3[/SUP], Fang F[SUP]1[/SUP], Zeng F[SUP]2[/SUP], Tian N[SUP]2[/SUP], Zhang Y[SUP]4[/SUP], Huang Y[SUP]5[/SUP], Sun Z[SUP]6[/SUP], Dhuromsingh M[SUP]7[/SUP], Li H[SUP]8[/SUP], Li Y[SUP]9[/SUP], Xu R[SUP]1[/SUP], Chen Y[SUP]1[/SUP], Luo X[SUP]1[/SUP].
Author information
Abstract
BACKGROUND:
The outbreak of coronavirus disease 2019 (COVID-19) is becoming a global threat. However, our understanding of the clinical characteristics and treatment of critically ill pediatric patients and their ability of transmitting the coronavirus that causes COVID-19 still remains inadequate because only a handful pediatric cases of COVID-19 have been reported.
METHODS:
Epidemiology, clinical characteristics, treatment, laboratory data and follow-up information and the treatment of critically ill infant were recorded.
RESULTS:
The infant had life-threatening clinical features including high fever, septic shock, recurrent apnea, petechiae and acute kidney injury and persistent declined CD3+, CD4+ and CD8+ T cells. The duration of nasopharyngeal virus shedding lasted for 49 days even with the administration of lopinavir/ritonavir for 8 days. The CD3+, CD4+ and CD8+ T cells was partially recovered 68 days post onset of the disease. Accumulating of effector memory CD4+ T cells (CD4+TEM) was observed among T-cell compartment. The nucleic acid tests and serum antibody for the severe acute respiratory syndrome coronavirus 2 of the infant's mother who kept intimate contact with the infant were negative despite no strict personal protection.
CONCLUSIONS:
The persistent reduction of CD4+ and CD8+ T cells was the typical feature of critically ill infant with COVID-19. CD4+ and CD8+ T cells might play a key role in aggravating COVID-19 and predicts a more critical course in children. The prolonged nasopharyngeal virus shedding was related with the severity of respiratory injury. The transmission of SARS-CoV-2 from infant (even very critical cases) to adult might be unlikely.
PMID:32379199DOI:10.1097/INF.0000000000002720