tetano
Editor, Senior Moderator
Sci Transl Med
. 2020 Sep 21;eabd5487.
doi: 10.1126/scitranslmed.abd5487. Online ahead of print.
Immune responses to SARS-CoV-2 infection in hospitalized pediatric and adult patients
Carl A Pierce[SUP] 1 [/SUP], Paula Preston-Hurlburt[SUP] 1 [/SUP], Yile Dai[SUP] 1 [/SUP], Clare Burn Aschner[SUP] 2 [/SUP], Natalia Cheshenko[SUP] 3 [/SUP], Benjamin Galen[SUP] 4 [/SUP], Scott J Garforth[SUP] 5 [/SUP], Natalia G Herrera[SUP] 5 [/SUP], Rohit K Jangra[SUP] 2 [/SUP], Nicholas C Morano[SUP] 5 [/SUP], Erika Orner[SUP] 6 [/SUP], Sharlene Sy[SUP] 3 [/SUP], Kartik Chandran[SUP] 2 [/SUP], James Dziura[SUP] 7 [/SUP], Steven C Almo[SUP] 5 [/SUP], Aaron Ring[SUP] 1 [/SUP], Marla J Keller[SUP] 4 [/SUP], Kevan C Herold[SUP] #[/SUP][SUP] 8 7 [/SUP], Betsy C Herold[SUP] #[/SUP][SUP] 9 3 [/SUP]
Affiliations
Abstract
Children and youth infected with SARS-CoV-2 have milder disease than do adults and, even among those with the recently described multi-system inflammatory syndrome (MIS-C), mortality is rare. The reasons for the differences in clinical manifestations are unknown, but suggest that age-dependent factors may modulate the anti-viral immune response. We compared cytokine, humoral, and cellular immune responses in pediatric (children and youth, age < 24 years) (n=65) and adult (n=60) patients with COVID-19 at a metropolitan hospital system in New York City. The pediatric patients had a shorter length of stay, decreased requirement for mechanical ventilation and lower mortality compared to adults. The serum concentrations of IL-17A and IFN-γ, but not TNF-α or IL-6, were inversely related to age. Adults mounted a more robust T cell response to the viral spike protein compared to pediatric patients as evidenced by increased expression of CD25+ on CD4+ T cells and the frequency of IFN-γ+CD4+ T cells. Moreover, serum neutralizing antibody titers and antibody-dependent cellular phagocytosis were higher in adults compared to pediatric COVID-19 patients. The neutralizing antibody titer correlated positively with age and negatively with IL-17A and IFN-γ serum concentrations. There were no differences in anti-spike protein antibody titers to other human coronaviruses. Together these findings demonstrate that the poor outcome in hospitalized adults with COVID-19 compared to children may not be attributable to a failure to generate adaptive immune responses.
. 2020 Sep 21;eabd5487.
doi: 10.1126/scitranslmed.abd5487. Online ahead of print.
Immune responses to SARS-CoV-2 infection in hospitalized pediatric and adult patients
Carl A Pierce[SUP] 1 [/SUP], Paula Preston-Hurlburt[SUP] 1 [/SUP], Yile Dai[SUP] 1 [/SUP], Clare Burn Aschner[SUP] 2 [/SUP], Natalia Cheshenko[SUP] 3 [/SUP], Benjamin Galen[SUP] 4 [/SUP], Scott J Garforth[SUP] 5 [/SUP], Natalia G Herrera[SUP] 5 [/SUP], Rohit K Jangra[SUP] 2 [/SUP], Nicholas C Morano[SUP] 5 [/SUP], Erika Orner[SUP] 6 [/SUP], Sharlene Sy[SUP] 3 [/SUP], Kartik Chandran[SUP] 2 [/SUP], James Dziura[SUP] 7 [/SUP], Steven C Almo[SUP] 5 [/SUP], Aaron Ring[SUP] 1 [/SUP], Marla J Keller[SUP] 4 [/SUP], Kevan C Herold[SUP] #[/SUP][SUP] 8 7 [/SUP], Betsy C Herold[SUP] #[/SUP][SUP] 9 3 [/SUP]
Affiliations
- PMID: 32958614
- DOI: 10.1126/scitranslmed.abd5487
Abstract
Children and youth infected with SARS-CoV-2 have milder disease than do adults and, even among those with the recently described multi-system inflammatory syndrome (MIS-C), mortality is rare. The reasons for the differences in clinical manifestations are unknown, but suggest that age-dependent factors may modulate the anti-viral immune response. We compared cytokine, humoral, and cellular immune responses in pediatric (children and youth, age < 24 years) (n=65) and adult (n=60) patients with COVID-19 at a metropolitan hospital system in New York City. The pediatric patients had a shorter length of stay, decreased requirement for mechanical ventilation and lower mortality compared to adults. The serum concentrations of IL-17A and IFN-γ, but not TNF-α or IL-6, were inversely related to age. Adults mounted a more robust T cell response to the viral spike protein compared to pediatric patients as evidenced by increased expression of CD25+ on CD4+ T cells and the frequency of IFN-γ+CD4+ T cells. Moreover, serum neutralizing antibody titers and antibody-dependent cellular phagocytosis were higher in adults compared to pediatric COVID-19 patients. The neutralizing antibody titer correlated positively with age and negatively with IL-17A and IFN-γ serum concentrations. There were no differences in anti-spike protein antibody titers to other human coronaviruses. Together these findings demonstrate that the poor outcome in hospitalized adults with COVID-19 compared to children may not be attributable to a failure to generate adaptive immune responses.