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2020 ; 55
(9
): 2354-2360
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Immune-related factors associated with pneumonia in 127 children with coronavirus
disease 2019 in Wuhan
#MMPMID32543756
Li Y
; Deng W
; Xiong H
; Li H
; Chen Z
; Nie Y
; Wang Z
; Li K
; Li J
Pediatr Pulmonol
2020[Sep]; 55
(9
): 2354-2360
PMID32543756
show ga
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 28 January to 12 March 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 nonintensive care unit patients, 48.8%
and 22.4% of patients had increased levels of procalcitonin and hypersensitive
C-reactive protein (hs-CRP) respectively. A total 12.6% and 18.1% of patients had
decreased levels of immunoglobulin A (IgA) and interleukin 10 (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?=?.005), IgA (OR, 4.00; 95% CI, 1.13-14.18; P?=?.032), and increased
levels of hs-CRP (OR, 3.14; 95% CI, 1.34-7.36; P?=?.008), procalcitonin (OR,
3.83; 95% CI, 2.03-7.24; P?.001), IL-10 (OR, 7.0; 95% CI, 1.59-30.80;
P?=?.010), and CD4(+) CD25(+) T lymphocyte less than 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.