Early Immune Responses and Prognostic Factors in Children with COVID-19: A Single-center Retrospective Analysis

Abstract

Background Early diagnostic indicators and the identification of possible progression to severe or critical COVID-19 in children are unknown. To investigate the immune characteristics of early SARS-CoV-2 infection in children and possible key prognostic factors for early identification of critical COVID-19, a retrospective study including 121 children with COVID-19 was conducted. Peripheral blood lymphocyte subset counts, T cell-derived cytokine concentrations, inflammatory factor concentrations, and routine blood counts were analyzed statistically at the initial presentation. Results The T lymphocyte subset and natural killer cell counts decreased with increasing disease severity. Group III (critical cases) had a higher Th/Tc ratio than groups I and II (common and severe cases); group I had a higher B cell count than groups II and III. IL-6, IL-10, IFN-γ, SAA, and procalcitonin levels increased with disease severity. Hemoglobin concentration, and RBC and eosinophil counts decreased with disease severity. Groups II and III had significantly lower lymphocyte counts than group I. T, Th, Tc, IL-6, IL-10, RBC, and hemoglobin had relatively high contribution and area under the curve values. Conclusions Decreased T, Th, Tc, RBC, hemoglobin and increased IL-6 and IL-10 in early SARS-CoV-2 infection in children are valuable indices for early diagnosis of disease severity. The significantly reduced Th and Tc cells and significantly increased IL-6, IL-10, ferritin, procalcitonin, and SAA at this stage in children with critical COVID-19 may be closely associated with the systemic cytokine storm caused by immune dysregulation.

The legacy of maternal SARS-CoV-2 infection on the immunology of the neonate

“…Perhaps unsurprisingly, cord plasma of neonates born to mothers with recent or ongoing infection, expressed elevated concentrations of some cytokines known to be associated with inflammation and COVID-19, consistent with placental immune activation 19 . Elevated levels of IP-10, IL-6, IL-10, CXCL8 and IL-1β have been associated with adult infection 20,21 , with increased IL-6 and IL-10 also associated with severity in SARS-CoV-2 infection in children 34 . Interestingly, this conventional COVID-19 signature was skewed more toward IL-10 (and to a lesser extent, CXCL8) in the neonates born to mothers with recent or ongoing infection.…”

The legacy of maternal SARS-CoV-2 infection on the immunology of the neonate

“…Previously, elevated levels of IP-10, IL-6, IL-10, CXCL8 and IL-1β have been associated with adult infection and the former three with disease severity 32 33 34 . Increased IL-6 and IL-10 have also been associated with severity in early SARS-CoV-2 infection in children 53 . Interestingly, this conventional COVID-19 signature of adults was skewed more towards IL-10 (and to a lesser extent, CXCL8) in the neonates born to mothers with recent/ongoing infection.…”

An explainable neural network integrating Jiles-Atherton and nonlinear auto-regressive exogenous models for modeling universal hysteresis

“…In order to solve the problem of model uncertainty, researchers have proposed a variety of solutions. Here are seven classical methods of quantifying uncertainty: Bootstrap method [64]; Bayesian method [65]; Fuzzy method [66]; Monte Carlo simulation (MCS) [67]; Genetic algorithm [68]; Sensitivity analysis [69]; Ensemble approach [70]. To deal with uncertainty, this paper first transforms the Jiles-Atherton model into a structured neural network.…”