Infected Children Research Articles

Urinary Tract Infections in Children

Patient Education| 2021 Urinary Tract Infections in Young Children Connected Content Translation: Infecciones de las vías urinarias en niños pequeños: (Urinary Tract Infections in Young Children) Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Share Icon Share Facebook Twitter LinkedIn Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Urinary Tract Infections in Young Children. Pediatric Patient Education 2021; 10.1542/peo_document109 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search nav search search input Search input auto suggest search filter All AAP SitesAll PublicationsPediatric Patient Education Search Advanced Search Topics: urinary tract, urinary tract infections, urine, urinary bladder, kidney, fever The urinary tract makes and stores urine. It is made up of the kidneys, ureters, bladder, and urethra (see illustration). The kidneys produce urine. Urine travels from the kidneys down 2 narrow tubes called the ureters to the bladder. The bladder is a thin muscular bag that stores urine until it is time to empty urine out of the body. When it is time to empty the bladder, a muscle at the bottom of the bladder relaxes. Urine then flows out of the body through a tube called the urethra. The opening of the urethra is at the end of the penis in boys and above the vaginal opening in girls. Normal urine has no germs (bacteria). However, bacteria can get into the urinary tract from 2 sources: (1) the skin around the rectum and genitals and (2) the... © 2010 American Academy of Pediatrics, Reaffirmed 01/2017. All rights reserved. You do not currently have access to this content.

Estimate of Some Immune-Biomarkers in Children with Entamoeba Histolytica Infection

The current work was aimed to evaluate of some immune-biomarkers in children with Entamoeba histolytica infection. General stool examination was done to patients for detection of E. histolytica infection. A total 150 patients of less than 13 years, whom attended the parasitology section at period February to June 2023. The chosen patients were suffered from abdominal pain and diarrhea. The results showed that gender is not related to infection with E. histolytica, as there were no significant (P≤0.05) differences between the proportions of males and females. The IgG concentration of infected children (24.05±3.94 ng/L) indicated a significant (P≤0.05) rise compared to the healthy children (11.72±2.55 ng/L). IgA concentration of infected children (159.42±18.62 ng/L) indicated a significant (P≤0.05) rise compared to the healthy children (38.93±7.01 ng/L). IgM concentration of infected children (4.84±0.45 ng/L) indicated a significant (P≤0.05) rise compared to the healthy children (2.17±0.35 ng/L). The IL-4 concentration of infected children (29.47±4.04 pg/ml) indicated a significant (P≤0.05) rise compared to the healthy children (16.54±3.94 pg/ml). IL-6 concentration of infected children (183.25±21.37 pg/ml) indicated a significant (P≤0.05) rise compared to the healthy children (26.12±4.51 pg/ml). The TLR2 levels of infected children (24.05±3.94 ng/L) indicated a significant (P≤0.05) rise compared to the healthy children (11.72±2.55 ng/L). therefore, its concluded that E. histolytica lead to a high immune response that leads to an increase in levels of immune parameters in infected children

Causes of Childhood Cancer: A Review of the Recent Literature: Part I-Childhood Factors.

To review the childhood risk factors for pediatric cancer (diagnosis before age 20). We conducted literature searches using Ovid Medline and Scopus to find primary research studies, review articles, and meta-analyses published from 2014 to 3 March 2021. Strong evidence indicates that an array of genetic and epigenetic phenomena, structural birth defects, and chromosomal anomalies are associated with an increased risk of various childhood cancers. Increased risk is also associated with prior cancer, likely due to previous treatment agents and therapeutic ionizing radiation. Convincing evidence supports associations between several pediatric cancers and ionizing radiation, immunosuppression, and carcinogenic virus infection both in healthy children and in association with immune suppression following organ transplantation. Breastfeeding and a childhood diet rich in fruits and vegetables appears to reduce the risk of pediatric leukemia but the evidence is less strong. Childhood vaccination against carcinogenic viruses is associated with a lower risk of several cancers; there is less strong evidence that other childhood vaccinations more broadly may also lower risk. Ultraviolet (UV) radiation is associated with increased melanoma risk, although most melanomas following childhood UV exposure occur later, in adulthood. Evidence is weak or conflicting for the role of body mass index, other childhood infections, allergies, and certain treatments, including immunomodulator medications and human growth therapy.

SARS-CoV-2-specific mucosal immune response in vaccinated versus infected children.

The anti-COVID-19 intramuscular vaccination induces a strong systemic but a weak mucosal immune response in adults. Little is known about the mucosal immune response in children infected or vaccinated against SARS-CoV-2. We found that 28% of children had detectable salivary IgA against SARS-CoV-2 even before vaccination, suggesting that, in children, SARS-CoV-2 infection may be undiagnosed. After vaccination, only receptor-binding domain (RBD)-specific IgA1 significantly increased in the saliva. Conversely, infected children had significantly higher salivary RBD-IgA2 compared to IgA1, indicating that infection more than vaccination induces a specific mucosal immune response in children. Future efforts should focus on development of vaccine technologies that also activate mucosal immunity.

Enterococcal Central Nervous System Infections in Children: A 22 Years' Experience in a Tertiary Center and Review of the Literature.

Enterococcal meningitis in children is rare, and its clinical presentation, laboratory characteristics and outcomes are not well defined. We conducted a retrospective analysis of Enterococcal meningitis cases during 2002-2023 at our tertiary center. We identified 10 cases in children 2 weeks to 15 years old (median age: 8 months). Seven children were males and 9 had comorbidities, including a ventriculoperitoneal shunt in 5 children. All children with shunt infections presented with nonspecific signs and symptoms. While 8 children presented with fever, only 3 had signs of meningeal irritation and altered consciousness. Cerebrospinal fluid pleocytosis was evident in almost all children with a median of 173 cells/mL. Nine cases were due to Enterococcus faecalis , and 1 case was due to E. faecium . All 5 children with ventriculoperitoneal shunt underwent shunt removal and replacement. All children recovered without documented sequelae. Enterococcal meningitis is rare, especially in healthy neonates. It typically occurs following neurosurgical interventions and may only present with fever and shunt malfunction, without overt meningeal signs and with mild inflammation. The prognosis is favorable.

Exploring Clinical Predictors of Severe Human Metapneumovirus Respiratory Tract Infections in Children: Insights from a Recent Outbreak.

Human metapneumovirus (hMPV) is an important pathogen that causes both upper (URTIs) and lower respiratory tract infections (LRTIs) in children. The virus can be implicated in severe bronchiolitis and pneumonia, necessitating hospitalization, with certain cases requiring intensive care unit intervention. As part of a retrospective observational study, we aimed to identify indicators of severe hMPV respiratory tract infections in children referred to the University Children's Hospital Ljubljana and the Department of Infectious Diseases Ljubljana, Slovenia, during a recent outbreak. We analyzed clinical data from November 2022 to January 2023 and compared the characteristics of children presenting with URTIs and LRTIs. We also examined the characteristics of children with hMPV LRTIs, distinguishing between children with and without LRTI-associated hypoxemia. Of 78 hMPV-PCR-positive pediatric patients (mean age 3.1 years; 60.3% boys), 36% had a URTI, and 64% had an LRTI. Hospitalization was required in 64% (50/78), with 42% (21/50) requiring oxygen therapy. LRTI-associated hypoxemia was more common in patients with atopy who showed dyspnea, tachypnea, crackles, and wheezing on lung auscultation. In a multivariable logistic regression analysis, wheezing detected on lung auscultation was a significant predictive factor for hypoxemic hMPV-LRTI. Specifically, children presenting with wheezing were found to be ten times more likely to experience hypoxemia. Prematurity and chronic conditions did not influence the presentation or severity of hMPV infection. This study highlights wheezing and atopy as crucial indicators of severe hMPV LRTI in children, emphasizing the importance of early recognition and intervention.

Aetiological agents of pneumonia among HIV and non-HIV infected children in Ghana: A case-control study.

Pneumonia is the leading cause of death in children, however, the microbial aetiology of pneumonia is not well elucidated in low- and middle-income countries. Our study was aimed at determining the microbial aetiologies of childhood pneumonia and associated risk factors in HIV and non-HIV infected children. We conducted a case-control study that enrolled children with pneumonia as cases and non-pneumonia as controls from July 2017 to May 2020. Induced sputum and blood samples were investigated for microbial organisms using standard microbiological techniques. DNA/RNA was extracted from sputum samples and tested for viral and bacterial agents. Four hundred and four (404) subjects consisting of 231 (57.2%) cases and 173 (42.8%) controls were enrolled. We identified a significant (p = 0.011) proportion of viruses in cases (125; 54.1%, 95%CI: 47.4-60.7) than controls (71; 33.6%, 95%CI: 33.6-48.8) and these were mostly contributed to by Respiratory Syncytial Virus. Staphylococcus aureus (16; 4.0%), Klebsiella spp. (15, 3.7%) and Streptococcus pneumoniae (8, 2.0%) were the main bacterial agents identified in sputum or induced sputum samples. HIV infected children with viral-bacterial co-detection were found to have very severe pneumonia compared to those with only viral or bacterial infection. Indoor cooking (OR = 2.36; 95%CI:1.41-3.96) was found to be associated with pneumonia risk in patients. This study demonstrates the importance of various microbial pathogens, particularly RSV, in contributing to pneumonia in HIV and non-HIV paediatric populations. There is a need to accelerate clinical trials of RSV vaccines in African populations to support improvement of patient care.

Gram-Positive Blood Stream Infections in Children After Cardiac Surgery

Gram-Positive Blood Stream Infections in Children After Cardiac Surgery

Adoption of C-reactive protein rapid tests for the management of acute childhood infections in hospitals in the Netherlands and England: a comparative health systems analysis

BackgroundThe adoption of C-reactive protein point-of-care tests (CRP POCTs) in hospitals varies across Europe. We aimed to understand the factors that contribute to different levels of adoption of CRP POCTs for the management of acute childhood infections in two countries.MethodsComparative qualitative analysis of the implementation of CRP POCTs in the Netherlands and England. The study was informed by the non-adoption, abandonment, spread, scale-up, and sustainability (NASSS) framework. Data were collected through document analysis and qualitative interviews with stakeholders. Documents were identified by a scoping literature review, search of websites, and through the stakeholders. Stakeholders were sampled purposively initially, and then by snowballing. Data were analysed thematically.ResultsForty-one documents resulted from the search and 46 interviews were conducted. Most hospital healthcare workers in the Netherlands were familiar with CRP POCTs as the tests were widely used and trusted in primary care. Moreover, although diagnostics were funded through similar Diagnosis Related Group reimbursement mechanisms in both countries, the actual funding for each hospital was more constrained in England. Compared to primary care, laboratory-based CRP tests were usually available in hospitals and their use was encouraged in both countries because they were cheaper. However, CRP POCTs were perceived as useful in some hospitals of the two countries in which the laboratory could not provide CRP measures 24/7 or within a short timeframe, and/or in emergency departments where expediting patient care was important.ConclusionsCRP POCTs are more available in hospitals in the Netherlands because of the greater familiarity of Dutch healthcare workers with the tests which are widely used in primary care in their country and because there are more funding constraints in England. However, most hospitals in the Netherlands and England have not adopted CRP POCTs because the alternative CRP measurements from the hospital laboratory are available in a few hours and at a lower cost.

Investigating Nonspecific Effects of the Live-Attenuated Japanese Encephalitis Vaccine on Lower Respiratory Tract Infections in Children Aged 25-35 Months: Retrospective Cohort Study.

Live attenuated vaccines may be used to prevent nontargeted diseases such as lower respiratory tract infections (LRTIs) due to their nonspecific effects (NSEs). We aimed to analyze the NSEs of the Japanese encephalitis vaccine on pediatric LRTIs in children aged 25 months to 35 months. A retrospective cohort study was conducted by using a population-based electronic health record database in Zhejiang, China. Enrolled participants were children born from January 1, 2017, to December 31, 2017, and who were inoculated with the live-attenuated Japanese encephalitis vaccine (JE-L) or inactivated Japanese encephalitis vaccine (JE-I) as the most recent vaccine at 24 months of age. The study was carried out between January 1, 2019, and December 31, 2019. All inpatient and outpatient hospital visits for LRTIs among children aged 25 months to 35 months were recorded. The Andersen-Gill model was used to assess the NSEs of JE-L against LRTIs in children and compared with those of JE-I as the most recent vaccine. A total of 810 children born in 2017 were enrolled, of whom 585 received JE-L (JE-L cohort) and 225 received JE-I (JE-I cohort) as their last vaccine. The JE-L cohort showed a reduced risk of LRTIs (adjusted hazard ratio [aHR] 0.537, 95% CI 0.416-0.693), including pneumonia (aHR 0.501, 95% CI 0.393-0.638) and acute bronchitis (aHR 0.525, 95% CI 0.396-0.698) at 25 months to 35 months of age. The NSEs provided by JE-L were especially pronounced in female children (aHR 0.305, 95% CI 0.198-0.469) and children without chronic diseases (aHR 0.553, 95% CI 0.420-0.729), without siblings (aHR 0.361, 95% CI 0.255-0.511), with more than 30 inpatient and outpatient hospital visits prior to 24 months of age (aHR 0.163, 95% CI 0.091-0.290), or with 5 to 10 inpatient and outpatient hospital visits due to infectious diseases prior to 24 months old (aHR 0.058, 95% CI 0.017-0.202). Compared with JE-I, receiving JE-L as the most recent vaccine was associated with lower risk of inpatient and outpatient hospital visits for LRTIs among children aged 25 months to 35 months. The nature of NSEs induced by JE-L should be considered for policymakers and physicians when recommending JE vaccines to those at high risk of infection from the Japanese encephalitis virus.

The Influence of Parenting Patterns, Diarrhea Diseases and Infections on the Incidence of Stunting Toddlers in Poor Families in Medan City

<p><em>Stunting is a long-term reflection of inadequate food quality and quantity and frequent childhood infections, especially in low economic conditions or poor families. This study aims to analyze the effect of parenting patterns on breastfeeding and complementary feeding, food preparation, environmental hygiene and sanitation practices, caring for children when sick, infectious diseases of diarrhea and Acute Respiratory Infection on the incidence of stunting in toddlers in poor families in Medan City. This research method used a case-control approach. This study was conducted in the Medan City area from November 2022 to December 2023. The study sample population was 364. The study sample was 105 children from poor families by comparing the number of samples in the case group and control samples, namely 35 samples in the case group and 70 in the control group. The sampling technique was carried out using the cluster sampling method. Data were collected using a questionnaire in the form of an interview. The incidence of stunting in children was obtained from the measurement of children's height using a toddler height meter. Data collection used primary data through questionnaires and secondary data through Child Identity Card book data. Data analysis with descriptive univariate analysis, bivariate analysis with chi-square test and multivariate analysis with logistic regression. data processing using SPSS software version 16.0. The results showed that there was a significant influence between breastfeeding and complementary feeding (p-value 0.006) and environmental sanitation hygiene practices (p-value = 0.017) on the incidence of stunting in toddlers from poor families. The dominant factor influencing the incidence of stunting in Medan City is the factor of breastfeeding and complementary feeding that is not good has a risk of 3.473 times experiencing stunting compared to children with good breastfeeding and complementary feeding. </em></p><p><em> </em></p><strong><em>Keywords: Parenting, Poor Family, Stunting, Toddler</em></strong>

COVID-19, Influenza, and RSV in Children and Adults: A Clinical Comparative Study of 12,000 Cases.

(1) Background: Respiratory virus infections, including Coronavirus disease 2019 (COVID-19), seasonal influenza (FLU), and respiratory syncytial virus (RSV) as prominent examples, can severely affect both children and adults. This study aimed to investigate the clinical characteristics of respiratory viral infections in pediatric and adult populations and to identify determinants influencing patient hospitalization. (2) Methods: This retrospective study analyzed the electronic medical records of patients admitted to a regional hospital's emergency department from 1 January 2015 to 31 December 2022, to investigate the clinical characteristics and hospitalization risk factors associated with these three viruses. (3) Results: Infants aged 1 to 11 months were most affected by COVID-19 and RSV, whereas FLU more commonly infected children aged 3 to 5 years. Key factors influencing hospitalization included age and abnormal chest X-ray findings, with higher risks observed in younger children and adults over 65. Notably, the presence of abnormal chest x-ray findings significantly increased the hospitalization risk by 1.9 times [1.5-2.4] in children and 21.4 times [2.4-189.0] in adults. (4) Conclusions: This analysis underscores the impact of COVID-19, FLU, and RSV on hospitalization risk, offering insights for managing these respiratory viral infections (RVIs). Age-related risk differences highlight the necessity for tailored strategies, improving understanding of and treatment development for RVIs.

Estimate of Some Immune-Biomarkers in Children with Entamoeba Histolytica Infection

The current work was aimed to evaluate of some immune-biomarkers in children with Entamoeba histolytica infection. General stool examination was done to patients for detection of E. histolytica infection. A total 150 patients of less than 13 years, whom attended the parasitology section at period February to June 2023. The chosen patients were suffered from abdominal pain and diarrhea. The results showed that gender is not related to infection with E. histolytica, as there were no significant (P≤0.05) differences between the proportions of males and females. The IgG concentration of infected children (24.05±3.94 ng/L) indicated a significant (P≤0.05) rise compared to the healthy children (11.72±2.55 ng/L). IgA concentration of infected children (159.42±18.62 ng/L) indicated a significant (P≤0.05) rise compared to the healthy children (38.93±7.01 ng/L). IgM concentration of infected children (4.84±0.45 ng/L) indicated a significant (P≤0.05) rise compared to the healthy children (2.17±0.35 ng/L). The IL-4 concentration of infected children (29.47±4.04 pg/ml) indicated a significant (P≤0.05) rise compared to the healthy children (16.54±3.94 pg/ml). IL-6 concentration of infected children (183.25±21.37 pg/ml) indicated a significant (P≤0.05) rise compared to the healthy children (26.12±4.51 pg/ml). The TLR2 levels of infected children (24.05±3.94 ng/L) indicated a significant (P≤0.05) rise compared to the healthy children (11.72±2.55 ng/L). therefore, its concluded that E. histolytica lead to a high immune response that leads to an increase in levels of immune parameters in infected children

Long-term Ocular Outcomes in Congenital Toxoplasmosis Treated Perinatally.

Congenital toxoplasmosis (CT) can be accompanied by serious organ manifestations, particularly retinochoroiditis, and may occur throughout life. We aimed to monitor long-term ocular prognosis in a large French cohort of patients with CT and its changes over time in the context of mandatory prenatal screening (since 1992) and incidence decrease since 2008. Patients with CT diagnosed between 1987 and 2021 were prospectively included and followed for up to 35 years. The effect of the period of conception on the risk of first retinochoroiditis has been tested using a flexible extension of the Cox model. Incidence rates of retinochoroiditis were estimated. A total of 646 infected live born children were followed for a median of 12 years (range, 0.5-35); 187 patients (29%) had at least 1 ocular lesion (first at a median age of 5 years; range, 0-26 years) with peaks at 7 and 12 years. Early maternal infection and the presence of nonocular signs at birth were associated with a higher risk of retinochoroiditis, whereas delayed diagnosis of CT (after birth versus before or at birth) was associated with a lower risk (13% decrease for each additional month after birth; P = .01). A period effect for the risk of developing retinochoroiditis in patients born after 2008 was not detected. Despite prenatal screening and prolonged perinatal treatment, retinochoroiditis is not a rare event in French patients with CT and can occur well into adulthood, with peak incidences at 7 and 12 years of age. It rarely causes severe damage but warrants regular follow-up into adulthood.

Congenital CMV infection in a Brazilian neonatal intensive care unit: high prevalence among twin newborns

BackgroundCytomegalovirus (CMV) is one of the most important pathogens associated with congenital infection worldwide. Most congenital CMV-infected infants are asymptomatic at birth; however, some can develop delayed sequelae, especially hearing loss.MethodsThis study aimed to investigate the prevalence of congenital CMV infection in a neonatal intensive care unit in a low-income region of Brazil. The objectives extended to identifying associated factors, assessing the clinical status of infected newborns, and undertaking a two-year follow-up to discern potential long-term consequences in the affected infants. This cross-sectional prospective study enrolled newborns up to three weeks of life requiring intensive medical care. We employed a convenience sampling method to include 498 newborns and 477 mothers in the study. Categorical variables underwent analysis employing Fisher’s exact test, whereas the examination of continuous variables involved the Mann‒Whitney test.ResultsCMV DNA was detected in saliva/urine samples from 6 newborns (1.21%), confirming congenital infection. We noted a significantly greater incidence (OR: 11.48; 95% CI: 2.519–52.33; p = 0.0094) of congenital infection among twins (7.14%) than among nontwins (0.66%). The twin patients exhibited discordant infection statuses, suggesting that only one of the babies tested positive for CMV. Most of the infected children were born to mothers who initiated sexual activity at a younger age (p = 0.0269). Only three out of the six newborns diagnosed with CMV infection underwent comprehensive clinical assessments and received continuous follow-up until they reached two years of age. Only one of the children had weight and height measurements below the norm for their age, coupled with developmental delays.ConclusionsThe prevalence of congenital CMV infection among newborns admitted to the NICU was low and similar to that in the general population. However, we found a significantly greater incidence of congenital CMV infection in twins than in singletons. Interestingly, the twin-infected patients exhibited discordant infection statuses, suggesting that CMV was present in only one of the babies. We also found that most of the infected children were born to mothers who initiated sexual activity at a younger age. Diagnostic accessibility and comprehensive surveillance programs are imperative for effectively managing and preventing congenital CMV infections.

Evaluation of Etiologic Agents of Lower Respiratory Tract Infections in Children Hospitalized Just Before Normalization of COVID-19

Lower respiratory tract infections (LRTIs) are one of the most common causes of hospitalization among children in the earlychildhood period. Knowing the pathogens that cause pneumonia, its management will be more exact and effective. In this study,we aimed to investigate the frequency of pathogens causing LRTIs in children at the end of the COVID-19 pandemic by performinga real-time multiplex polymerase chain reaction (RT-MPCR) test within our hospital. We included two hundred forty-seven children,aged between 1 month and 18 years, diagnosed with LRTIs, and hospitalized between May 2021 and April 2022. Demographiccharacteristics and clinical and laboratory findings were retrospectively collected from patients’ hospital records. Of the 247 childrendiagnosed with LRTIs, 153 (61.9%) were female. At least one pathogen was identified in the nasopharyngeal swap specimens of218 (88.3%) patients, and 74.9% (n=185) of them were viruses. The most common identified pathogens were respiratory syncytialvirus (24.7%), human bocavirus (21.1%), and severe acute respiratory syndrome coronavirus 2 (15.4%). 7.7% of identifiedpathogens were bacteria. Haemophilus influenzae was the most commonly detected bacteria. Despite a lengthy period of isolatingthe community causative agents of pneumonia, their frequency remains unchanged from before the isolation time. RT-MPCR isbeneficial for the early detection of pathogens and in the prevention of unnecessary antibiotic usage.

Effect of probiotics on urinary tract infections in children: A systematic review and meta-analysis.

Urinary tract infections (UTIs) are the most prevalent bacterial infections that occur in children worldwide. This meta-analysis aims to investigate the utility of probiotics as preventive therapy in children with a UTI. The Web of Science, PubMed, and Scopus were searched for articles that investigated the relationship between probiotic consumption and the risk of UTIs. The quality of the articles was evaluated using the Jadad scale. The pooled odds ratio (OR) and 95% confidence interval (CI) were calculated using a random-effects model. Subgroup analyses and sensitivity analyses were also conducted. The Cochran Q test and the statistic I2 were used to evaluate heterogeneity. To determine any potential publication bias, the Egger's and Begg's tests were used. In total, eleven studies were selected for systematic review and meta-analysis. Compared to children who did not receive probiotics, the OR of developing or having a recurring urinary tract infection in those who received probiotics was 0.94 (95% CI; 0.88-0.999; p-value=0.046). The Begg's and Egger's tests showed no evidence of publication bias between probiotics and the risk of developing new or recurring urinary tract infections. Based on this systematic review and meta-analysis, probiotics could be an alternative therapy for children who are at risk of developing a UTI. They are non-pharmaceutical options and could be used as natural prophylaxis for UTIs. However, the currently published evidence does not irrefutably confirm that probiotics provide a protective effect against urinary bacterial infections. Therefore, there need to be large-scale randomized clinical trials undertaken to investigate the possible prophylaxis of probiotics.

Indian Academy of Pediatrics Consensus Statement on Diagnosis and Management of Bone and Joint Infections in Children

Indian Academy of Pediatrics Consensus Statement on Diagnosis and Management of Bone and Joint Infections in Children

Acute Necrotizing Encephalopathy Associated with SARS-CoV-2 Infection in Children.

Acute Necrotizing Encephalopathy Associated with SARS-CoV-2 Infection in Children.

Delineating immune variation between adult and children COVID-19 cases and associations with disease severity

The SARS-CoV-2 pandemic has emphasized the need to explore how variations in the immune system relate to the severity of the disease. This study aimed to explore inter-individual variation in response to SARS-CoV-2 infection by comparing T cell, B cell, and innate cell immune subsets among primary infected children and adults (i.e., those who had never experienced SARS-CoV-2 infection nor received vaccination previously), with varying disease severity after infection. We also examined immune subset kinetics in convalescent individuals compared to those with persistent infection to identify possible markers of immune dysfunction. Distinct immune subset differences were observed between infected adults and children, as well as among adult cases with mild, moderate, and severe disease. IgM memory B cells were absent in moderate and severe cases whereas frequencies of B cells with a lack of surface immunoglobulin expression were significantly higher in severe cases. Interestingly, these immune subsets remained stable during recovery implying that these subsets could be associated with underlying baseline immune variation. Our results offer insights into the potential immune markers associated with severe COVID-19 and provide a foundation for future research in this area.