tetano
Editor, Senior Moderator
Pediatr Pulmonol
. 2020 Jun 16.
doi: 10.1002/ppul.24907. Online ahead of print.
Immune-related Factors Associated With Pneumonia in 127 Children With Coronavirus Disease 2019 in Wuhan
Yi Li[SUP] 1 [/SUP], Wenyue Deng[SUP] 2 [/SUP], Hao Xiong[SUP] 1 [/SUP], Hui Li[SUP] 1 [/SUP], Zhi Chen[SUP] 1 [/SUP], Yingming Nie[SUP] 1 [/SUP], Zhuo Wang[SUP] 1 [/SUP], Kaili Li[SUP] 1 [/SUP], Jianxin Li[SUP] 1 [/SUP]
Affiliations
Abstract
Objective: Information regarding the association of immune-related factors with pneumonia in children with coronavirus disease 2019 (COVID-19) is scarce. This study aims to summarize the immune-related factors and their association with pneumonia in children with COVID-19.
Methods: Children with COVID-19 at Wuhan Children's Hospital from January 28 to March 12, 2020 were enrolled. Pneumonia due to causes other than COVID-19 were excluded. The clinical and laboratory information including routine blood tests, blood biochemistry, lymphocyte subsets, immunoglobulins, cytokines and inflammatory factors were analyzed retrospectively in 127 patients. Normal ranges and mean values of laboratory markers were applied as parameters for logistic regression analyses of their association with pneumonia.
Results: In non-intensive care unit patients, 48.8% and 22.4% of patients had increased levels of procalcitonin and hypersensitive C-reactive protein (hs-CRP) respectively. 12.6% and 18.1% of patients had decreased levels of immunoglobulin (Ig) A and interleukin (IL)-10 respectively. Approximately 65.8% of patients had pneumonia. These patients had decreased levels of globulin (odds ratio [OR] 3.13, 95% confidence interval [CI] 1.41-6.93, P=0.005), IgA (OR 4.00, 95% CI 1.13-14.18, P=0.032), and increased levels of hs-CRP (OR 3.14, 95% CI 1.34-7.36, P=0.008), procalcitonin (OR 3.83, 95% CI 2.03-7.24, P<0.001), IL-10 (OR 7.0, 95% CI 1.59-30.80, P=0.010), and CD4+CD25+ T lymphocyte < 5.0 % (OR 1.93, 95% CI 1.04-3.61, P=0.038).
Conclusion: Decreased IgA and CD4+CD25+ T lymphocyte percentage, and increased hs-CRP, procalcitonin and IL-10 were associated with pneumonia, suggesting that the immune-related factors may participate in the pathogenesis of pneumonia in children with COVID-19. This article is protected by copyright. All rights reserved.
Keywords: children; coronavirus disease 2019; cytokine; immunoglobulin; pneumonia.
. 2020 Jun 16.
doi: 10.1002/ppul.24907. Online ahead of print.
Immune-related Factors Associated With Pneumonia in 127 Children With Coronavirus Disease 2019 in Wuhan
Yi Li[SUP] 1 [/SUP], Wenyue Deng[SUP] 2 [/SUP], Hao Xiong[SUP] 1 [/SUP], Hui Li[SUP] 1 [/SUP], Zhi Chen[SUP] 1 [/SUP], Yingming Nie[SUP] 1 [/SUP], Zhuo Wang[SUP] 1 [/SUP], Kaili Li[SUP] 1 [/SUP], Jianxin Li[SUP] 1 [/SUP]
Affiliations
- PMID: 32543756
- DOI: 10.1002/ppul.24907
Abstract
Objective: Information regarding the association of immune-related factors with pneumonia in children with coronavirus disease 2019 (COVID-19) is scarce. This study aims to summarize the immune-related factors and their association with pneumonia in children with COVID-19.
Methods: Children with COVID-19 at Wuhan Children's Hospital from January 28 to March 12, 2020 were enrolled. Pneumonia due to causes other than COVID-19 were excluded. The clinical and laboratory information including routine blood tests, blood biochemistry, lymphocyte subsets, immunoglobulins, cytokines and inflammatory factors were analyzed retrospectively in 127 patients. Normal ranges and mean values of laboratory markers were applied as parameters for logistic regression analyses of their association with pneumonia.
Results: In non-intensive care unit patients, 48.8% and 22.4% of patients had increased levels of procalcitonin and hypersensitive C-reactive protein (hs-CRP) respectively. 12.6% and 18.1% of patients had decreased levels of immunoglobulin (Ig) A and interleukin (IL)-10 respectively. Approximately 65.8% of patients had pneumonia. These patients had decreased levels of globulin (odds ratio [OR] 3.13, 95% confidence interval [CI] 1.41-6.93, P=0.005), IgA (OR 4.00, 95% CI 1.13-14.18, P=0.032), and increased levels of hs-CRP (OR 3.14, 95% CI 1.34-7.36, P=0.008), procalcitonin (OR 3.83, 95% CI 2.03-7.24, P<0.001), IL-10 (OR 7.0, 95% CI 1.59-30.80, P=0.010), and CD4+CD25+ T lymphocyte < 5.0 % (OR 1.93, 95% CI 1.04-3.61, P=0.038).
Conclusion: Decreased IgA and CD4+CD25+ T lymphocyte percentage, and increased hs-CRP, procalcitonin and IL-10 were associated with pneumonia, suggesting that the immune-related factors may participate in the pathogenesis of pneumonia in children with COVID-19. This article is protected by copyright. All rights reserved.
Keywords: children; coronavirus disease 2019; cytokine; immunoglobulin; pneumonia.