【摘 要】
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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 ped
【机 构】
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Department of Neurology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Te
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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 Hos-pital 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 chil-dren 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 fac-tor 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.
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