Association between vaccinations and clinical manifestations in children with COVID-19

Abstract

Background: The infection rate of Coronavirus Disease 2019 in children was less than that in adults. However, the underlining reason is not well known.Methods: Children with COVID-19 were recruited from two Children's Hospitals in Wuhan and Shanghai in this case-control study. The associations of initial symptoms with age, vaccinations of Bacillus Calmette Guerin (BCG), and influenza and pathogens were determined by Chi-square t-test.Results: We evaluated 248 confirmed cases, and 56 suspected cases with COVID-19. The median age was 6.82 years old, and 118 cases (38.82%) were girls. Furthermore, 30.26% of all patients were asymptomatic cases. The percentage of asymptomatic cases vaccinated with BCG was not significantly higher than that without BCG vaccination [86/280 (30.71%) vs. 6/13 (46.15%), P=0.203], and initial symptoms were not related with immunized influenza vaccine (P=0.267). Compared to parameters in pediatric patients with normal body temperatures, patients with fever had higher C reactive protein (CRP) (P<0.001).Conclusions: Pediatric COVID-19 patients with BCG vaccinations exhibit similar clinical manifestations compared to those without BCG vaccinations, and the severity of symptoms in pediatric patients may be related to the maturity of immune function.

Citizen science initiative points at childhood BCG vaccination as a risk factor for COVID‐19

“…Regarding COVID-19, it has been proposed that trained innate immunity or heterologous T-cell responses induced by BCG vaccination may reduce disease incidence, morbidity and severity (Curtis et al, 2020;Giamarellos-Bourboulis et al, 2020;Jirjees et al, 2020;Kubota et al, 2020;Levi et al, 2021;Mantovani & Netea, 2020;Marín-Hernández et al, 2021;Pana et al, 2021;Wickramasinghe et al, 2020). However, considering the limitations of ecological studies, analyses of the links between BCG vaccination and COVID-19 incidence and mortality have shown no correlation (Hensel et al, 2020;Liu et al, 2021;Ricco & Ranzieri, 2021), negative correlation (Goswami et al, 2021;Singh et al, 2020) or changes in correlation patterns as the pandemic progresses (Kubota et al, 2020). Other factors that have been proposed to affect SARS-CoV-2 infection and disease morbidity and mortality include ABO blood group (higher and lower susceptibility to infection in individuals with A and O blood groups, respectively) (Hodžić et al, 2020;Wu et al, 2020), age (older age associated with COVID-19 severity and mortality) (Ho et al, 2020), antibody levels against glycan Galα1-3Galβ1-(3)4GlcNAc-R (α-Gal) present in midgut microbiota (lower antibody levels associated with higher disease severity) (Urra et al, 2020) and sex (male patients appear to be at higher risk of mortality) (Ritter & Kararigas, 2020).…”

Health QR Code Application in the Novel Containment Strategy and Healthcare Plan for Pregnant Women and Children Under Quarantine During the Summer Outbreak of SARS-CoV-2 Delta Variant in Chengdu, China: An Observational Study

“…Due to the low vaccination rate of pregnant women and children in China, they are susceptible to the Delta variant. 10,11 Evidence also showed that COVID-19 infected pregnant women had a higher ICU admission rate than those without gestation. 12 Therefore, we formulated a detailed plan for providing healthcare to children and pregnant women in quarantine.…”

“…9 Pregnant women and children in China are presumably vulnerable to the Delta strain due to their low vaccination rate. 10,11 It was reported that the pregnant women have a significantly higher ICU admission rate if infected by the SARS-Cov-2. 12 Previous publications also indicated that pregnant women and children under quarantine had higher rates of depressive symptoms, anxiety, and other negative effects.…”

The COVID-19 pandemic in children and young people during 2020-2021: Learning about clinical presentation, patterns of spread, viral load, diagnosis and treatment

“…The percentage of asymptomatic cases vaccinated with BCG was not significantly higher than that without BCG vaccination (30.7% vs 46.2%, P = 0.203). Initial symptoms were not related to the immunized influenza vaccine ( P = 0.267) [ 31 ]. Seropositive young adults had about one-fifth the risk of subsequent infection compared with seronegative individuals.…”