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Characteristics of immune and inflammatory responses among different age groups of pediatric patients with COVID-19 in China 
Characteristics of immune and inflammatory responses among different age groups of pediatric patients with COVID-19 in China
  Su-Qiong Ji, Min Zhang, Yong Zhang, Kun Xia, Yuan Chen, Qian Chu, Yong-Chang Wei, Fu-Ling Zhou, Bi-Tao Bu, Hong-Lei Tu, Ya-Yun Cao, Li-Ya Hu
 [Abstract] [Full Text] [PDF]   Pageviews: 1833 Times
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 (¡Ü 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 ¦Ã (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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World Journal of Pediatric Surgery

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