Immunocompromised Children and Young People Are at No Increased Risk of Severe COVID-19

Chappell, Harry; Patel, Ravin; Driessens, Corine; Tarr, Alexander W.; Irving, William L.; Tighe, Patrick J.; Jackson, Hannah J.; Harvey-Cowlishaw, T.; Mills, Lynne; Shaunak, Meera; Gbesemete, Diane; Leahy, Alice; Lucas, Jane S.; Faust, Saul N.

doi:10.2139/ssrn.3893560

Cited by 6 publications

(8 citation statements)

References 10 publications

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“…The available data on immunocompromised patients infected with the delta variant is limited. According to the study of Hadjadj and colleagues, the emergence of SARS-CoV-2 strains like the Delta variant (B.1.617.2) with increased viral form and immune escape potential, raises concerns among immunocompromised patients [139,140]. Recently, a new variant of concern (VOC) called Omicron was first identified on November 24, 2021, in an immunocompromised patient from Johannesburg, South Africa as a consequence of prolonged replication among PID patients [141][142][143][144][145].…”

Section: Immunodepressive Children During the Delta And Omicron Eramentioning

confidence: 99%

SARS-CoV-2 infection in pediatric population before and during the Delta (B.1.617.2) and Omicron (B.1.1.529) variants era

Khemiri

Ayouni

Triki

et al. 2022

Virol J

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Background COVID-19, the coronavirus disease that emerged in December 2019, caused drastic damage worldwide. At the beginning of the pandemic, available data suggested that the infection occurs more frequently in adults than in infants. In this review, we aim to provide an overview of SARS-CoV-2 infection in children before and after B.1.617.2 Delta and B.1.1.529 Omicron variants emergence in terms of prevalence, transmission dynamics, clinical manifestations, complications and risk factors. Methods Our method is based on the literature search on PubMed, Science Direct and Google Scholar. From January 2020 to July 2022, a total of 229 references, relevant for the purpose of this review, were considered. Results The incidence of SARS-CoV-2 infection in infants was underestimated. Up to the first half of May, most of the infected children presented asymptomatic or mild manifestations. The prevalence of COVID-19 varied from country to another: the highest was reported in the United States (22.5%). COVID-19 can progress and become more severe, especially with the presence of underlying health conditions. It can also progress into Kawasaki or Multisystem Inflammatory Syndrome (MIS) manifestations, as a consequence of exacerbating immune response. With the emergence of the B.1.617.2 Delta and B.1.1.529 Omicron variants, it seems that these variants affect a large proportion of the younger population with the appearance of clinical manifestations similar to those presented by adults with important hospitalization rates. Conclusion The pediatric population constitutes a vulnerable group that requires particular attention, especially with the emergence of more virulent variants. The increase of symptomatic SARS-CoV-2 infection and hospitalization rate among children highlights the need to extend vaccination to the pediatric population.

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Section: Immunodepressive Children During the Delta And Omicron Eramentioning

confidence: 99%

SARS-CoV-2 infection in pediatric population before and during the Delta (B.1.617.2) and Omicron (B.1.1.529) variants era

Khemiri

Ayouni

Triki

et al. 2022

Virol J

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“…The importance of IL-10/IFN-γ producing T cells have also been highlighted by two recent works: such a functional T cell profile was demonstrated to be defective in severe COVID-19 (30), while the presence of IL-10 producing Spike-specific T cells is characteristic of individuals with hybrid SARS-CoV-2 immunity (29) who demonstrate a robust immunity from re-infection (38,39). Of note, the demonstration that mRNA vaccination in IBD patients undergoing TNF inhibition results in the induction of T cells with an IFN-γ/IL-2/IL-10 secretion profile suggests that similar functional profiles might likewise be induced in virus-specific T cells after SARS-CoV-2 infection, explaining the clinical evidence that SARS-CoV-2 infection in different patients undergoing TNFi treatment is generally mild (40)(41)(42). In our own study, 6 patients who eventually developed COVID-19 all had a mild disease course and did not require hospitalization; 4 of whom were on TNFi.…”

Section: Discussionmentioning

confidence: 99%

Favourable vaccine-induced SARS-CoV-2 specific T cell response profile in patients undergoing immune-modifying therapies

Bert

Chan

et al. 2022

Preprint

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Patients undergoing immune-modifying therapies demonstrate a reduced humoral response after COVID-19 vaccination, but we lack a proper evaluation of the impact of such therapies on vaccine-induced T cell responses. Here, we longitudinally characterised humoral and Spike-specific T cell responses in IBD patients who are on antimetabolite therapy (azathioprine or methotrexate), TNF inhibitors and/or other biologic treatment (anti-integrin or anti-p40) after mRNA vaccination. We demonstrated that a Spike-specific T cell response is not only induced in treated IBD patients at levels similar to healthy individuals, but also sustained at higher magnitude, particularly in those treated with TNF inhibitor therapy. Furthermore, the Spike-specific T cell response in these patients is mainly preserved against mutations present in SARS-CoV-2 B.1.1.529 (Omicron) and characterized by a Th1/IL-10 cytokine profile. Thus, despite the humoral response defects, the favourable profile of vaccine-induced T cell responses might still provide a layer of COVID-19 protection to patients under immune-modifying therapies.

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“…Of note, in a prospective study of 1527 immunocompromised children from 46 hospitals in the United Kingdom, only 4 children required hospital admission with confirmed SARS-CoV-2 infection, and there were no cases of severe COVID-19 or death. 40 Obesity is consistently reported to confer a significant risk for severe disease in both adults and children. 36,41 This is important in many high-income countries where a large proportion of children and adolescents are classified as obese (eg, Australia 8.2%; the United States 19.3% including 6.1% with severe obesity).…”

Section: Risk Factors For Severe Covid-19 In Childrenmentioning

confidence: 99%

Section: Part 2: Symptomatic Children Who Are Not Hypoxicmentioning

confidence: 99%

An Approach to the Treatment of Children With COVID-19

Boast

Curtis

Holschier

et al. 2022

Pediatric Infectious Disease Journal

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Immunocompromised Children and Young People Are at No Increased Risk of Severe COVID-19

Cited by 6 publications

References 10 publications

SARS-CoV-2 infection in pediatric population before and during the Delta (B.1.617.2) and Omicron (B.1.1.529) variants era

SARS-CoV-2 infection in pediatric population before and during the Delta (B.1.617.2) and Omicron (B.1.1.529) variants era

Favourable vaccine-induced SARS-CoV-2 specific T cell response profile in patients undergoing immune-modifying therapies

An Approach to the Treatment of Children With COVID-19

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