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EClinicalMedicine . . Reduced inflammatory responses to SARS-CoV-2 infection in children presenting to hospital with COVID-19 in China

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  • EClinicalMedicine . . Reduced inflammatory responses to SARS-CoV-2 infection in children presenting to hospital with COVID-19 in China


    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 1 2 , Yong Zhang 3 , Yang Xu 4 , Weihua Hu 5 , Ian P Hall 2 , Jiang Yue 6 , Hongyun Lu 7 , Liemin Ruan 8 , Maoqing Ye 9 , Jin Mei 10



    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.

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