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Recovering or Persisting: The Immunopathological Features of SARS-CoV-2 Infection in Children

Authors :
Danilo Buonsenso
Piero Valentini
Cristina De Rose
Maria Tredicine
Maria del Carmen Pereyra Boza
Chiara Camponeschi
Rosa Morello
Giuseppe Zampino
Anna E. S. Brooks
Mario Rende
Francesco Ria
Maurizio Sanguinetti
Giovanni Delogu
Michela Sali
Gabriele Di Sante
on behalf of the Gemelli-Pediatric COVID-19 Team
Source :
Journal of Clinical Medicine, Vol 11, Iss 15, p 4363 (2022)
Publication Year :
2022
Publisher :
MDPI AG, 2022.

Abstract

Background. The profile of cellular immunological responses of children across the spectrum of COVID-19, ranging from acute SARS-CoV-2 infection to full recovery or Long COVID, has not yet been fully investigated. Methods. We examined and compared cytokines in sera and cell subsets in peripheral blood mononuclear cells (B and regulatory T lymphocytes) collected from four distinct groups of children, distributed as follows: younger than 18 years of age with either acute SARS-CoV-2 infection (n = 49); fully recovered from COVID-19 (n = 32); with persistent symptoms (Long COVID, n = 51); and healthy controls (n = 9). Results. In the later stages after SARS-CoV-2 infection, the cohorts of children, both with recovered and persistent symptoms, showed skewed T and B subsets, with remarkable differences when compared with children at the onset of the infection and with controls. The frequencies of IgD+CD27− naïve B cells, IgD+IgM+ and CD27−IgM+CD38dim B cells were higher in children with recent infection than in those with an older history of disease (p < 0.0001 for all); similarly, the total and natural Tregs compartments were more represented in children at onset when compared with Long COVID (p < 0.0001 and p = 0.0005, respectively). Despite the heterogeneity, partially due to age, sex and infection incidence, the susceptibility of certain children to develop persistent symptoms after infection appeared to be associated with the imbalance of the adaptive immune response. Following up and comparing recovered versus Long COVID patients, we analyzed the role of circulating naïve and switched B and regulatory T lymphocytes in counteracting the evolution of the symptomatology emerged, finding an interesting correlation between the amount and ability to reconstitute the natural Tregs component with the persistence of symptoms (linear regression, p = 0.0026). Conclusions. In this study, we suggest that children affected by Long COVID may have a compromised ability to switch from the innate to the adaptive immune response, as supported by our data showing a contraction of naïve and switched B cell compartment and an unstable balance of regulatory T lymphocytes occurring in these children. However, further prospective immunological studies are needed to better clarify which factors (epigenetic, diet, environment, etc.) are involved in the impairment of the immunological mechanisms in the Long COVID patients.

Details

Language :
English
ISSN :
20770383
Volume :
11
Issue :
15
Database :
Directory of Open Access Journals
Journal :
Journal of Clinical Medicine
Publication Type :
Academic Journal
Accession number :
edsdoj.97671a46e12049e0ab60f153ba92354a
Document Type :
article
Full Text :
https://doi.org/10.3390/jcm11154363