Abstract
SummaryMild, subacute COVID-19 in young people show inflammatory enhancement, but normal pulmonary function. Inflammatory markers are associated with age and male sex, whereas clinical symptoms are associated with age and female sex, but not with objective disease markers.BackgroundCoronavirus Disease 2019 (COVID-19) is widespread among adolescents and young adults across the globe. The present study aimed to compare inflammatory markers, pulmonary function and clinical symptoms across non-hospitalized, 12 – 25 years old COVID-19 cases and non-COVID-19 controls, and to investigate associations between inflammatory markers, clinical symptoms, pulmonary function and background variables in the COVID-19 group.MethodsThe present paper presents baseline data from an ongoing longitudinal observational cohort study (Long-Term Effects of COVID-19 in Adolescents, LoTECA, ClinicalTrials ID: NCT04686734). A total of 31 plasma cytokines and complement activation products were assayed by multiplex and ELISA methodologies. Pulmonary function and clinical symptoms were investigated by spirometry and questionnaires, respectively.ResultsA total of 405 COVID-19 cases and 111 non-COVID-19 controls were included. The COVID-19 group had significantly higher plasma levels of IL-1β, IL-4, IL-7, IL-8, IL-12, TNF, IP-10, eotaxin, GM-CSF, bFGF, complement TCC and C3bc, and significantly lower levels of IL-13 and MIP-1α, as compared to controls. Spirometry did not detect any significant differences across the groups. IL-4, IL-7, TNF and eotaxin were negatively associated with female sex; eotaxin and IL-4 were positively associated with age. Clinical symptoms were positively associated with female sex and age, but not with objective disease markers.ConclusionsAmong non-hospitalized adolescents and young adults with COVID-19 there was significant alterations of plasma inflammatory markers in the subacute stage of the infection. Still, pulmonary function was normal. Clinical symptoms were independent of inflammatory and pulmonary function markers, but positively associated with age and female sex.
Highlights
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a single-stranded RNA virus responsible for the coronavirus disease 2019 (COVID-19) pandemic, which has caused morbidity and mortality all over the world [1]
IL-4, IL-7, Tumour Necrosis Factor (TNF) and eotaxin were negatively associated with female sex; eotaxin and IL-4 were positively associated with age
Two individuals had detectable total antibody-titre (IgG/IgM) against SARS-CoV-2, and these were excluded from further analyses; the sample carried over to analyses consists of 405 COVID-19 cases (39.5% males, mean age 17.8 years) and 109 non-COVID controls (34.9% males, mean age 17.7 years) (Table 1)
Summary
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a single-stranded RNA virus responsible for the coronavirus disease 2019 (COVID-19) pandemic, which has caused morbidity and mortality all over the world [1]. The pathophysiology of COVID-19 is incompletely understood, but has been linked to a disrupted and disproportionate response of the immune system, cytokine production [2, 3]. Uncontrolled release of pro-inflammatory cytokines, such as Interleukin (IL)-1b [4], IL-6 [5, 6], IL-8 [4], IL-17 [7] and Tumour Necrosis Factor (TNF) [4, 8], by immune and nonimmune effector cells is thought to contribute to the symptoms and severity of the disease [9]. The present study aimed to compare inflammatory markers, pulmonary function and clinical symptoms across non-hospitalized, 12 – 25 years old COVID-19 cases and non-COVID-19 controls, and to investigate associations between inflammatory markers, clinical symptoms, pulmonary function and background variables in the COVID-19 group
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