tetano
Editor, Senior Moderator
World J Pediatr
. 2021 Aug 2.
doi: 10.1007/s12519-021-00440-1. Online ahead of print.
Characteristics of immune and inflammatory responses among different age groups of pediatric patients with COVID-19 in China
Su-Qiong Ji[SUP] 1 [/SUP], Min Zhang[SUP] 2 [/SUP], Yong Zhang[SUP] 2 [/SUP], Kun Xia[SUP] 3 [/SUP], Yuan Chen[SUP] 4 [/SUP], Qian Chu[SUP] 4 [/SUP], Yong-Chang Wei[SUP] 5 [/SUP], Fu-Ling Zhou[SUP] 6 [/SUP], Bi-Tao Bu[SUP] 1 [/SUP], Hong-Lei Tu[SUP] 6 [/SUP], Ya-Yun Cao[SUP] 1 [/SUP], Li-Ya Hu[SUP] 7 [/SUP]
Affiliations
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.
Keywords: Age difference; China; Coronavirus disease 2019; Immune; Inflammation; Pediatric.
. 2021 Aug 2.
doi: 10.1007/s12519-021-00440-1. Online ahead of print.
Characteristics of immune and inflammatory responses among different age groups of pediatric patients with COVID-19 in China
Su-Qiong Ji[SUP] 1 [/SUP], Min Zhang[SUP] 2 [/SUP], Yong Zhang[SUP] 2 [/SUP], Kun Xia[SUP] 3 [/SUP], Yuan Chen[SUP] 4 [/SUP], Qian Chu[SUP] 4 [/SUP], Yong-Chang Wei[SUP] 5 [/SUP], Fu-Ling Zhou[SUP] 6 [/SUP], Bi-Tao Bu[SUP] 1 [/SUP], Hong-Lei Tu[SUP] 6 [/SUP], Ya-Yun Cao[SUP] 1 [/SUP], Li-Ya Hu[SUP] 7 [/SUP]
Affiliations
- PMID: 34341947
- DOI: 10.1007/s12519-021-00440-1
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.
Keywords: Age difference; China; Coronavirus disease 2019; Immune; Inflammation; Pediatric.