RT Journal Article
SR Electronic
T1 Immune responses to SARS-CoV-2 infection in hospitalized pediatric and adult patients
JF Science Translational Medicine
FD American Association for the Advancement of Science
SP eabd5487
DO 10.1126/scitranslmed.abd5487
A1 Pierce, Carl A.
A1 Dai, Yile
A1 Aschner, Clare Burn
A1 Cheshenko, Natalia
A1 Galen, Benjamin
A1 Garforth, Scott J.
A1 Herrera, Natalia G.
A1 Jangra, Rohit K.
A1 Morano, Nicholas C.
A1 Orner, Erika
A1 Sy, Sharlene
A1 Chandran, Kartik
A1 Dziura, James
A1 Almo, Steven C.
A1 Ring, Aaron
A1 Keller, Marla J.
A1 Herold, Kevan C.
A1 Herold, Betsy C.
YR 2020
UL http://stm.sciencemag.org/content/early/2020/09/16/scitranslmed.abd5487.abstract
AB Children and youth infected with SARS-CoV-2 have milder disease than do adults and, even among those with the recently described multi-system inflammatory syndrome (MIS-C), mortality is rare. The reasons for the differences in clinical manifestations are unknown, but suggest that age-dependent factors may modulate the anti-viral immune response. We compared cytokine, humoral, and cellular immune responses in pediatric (children and youth, age < 24 years) (n=65) and adult (n=60) patients with COVID-19 at a metropolitan hospital system in New York City. The pediatric patients had a shorter length of stay, decreased requirement for mechanical ventilation and lower mortality compared to adults. The serum concentrations of IL-17A and IFN-γ, but not TNF-α or IL-6, were inversely related to age. Adults mounted a more robust T cell response to the viral spike protein compared to pediatric patients as evidenced by increased expression of CD25+ on CD4+ T cells and the frequency of IFN-γ+CD4+ T cells. Moreover, serum neutralizing antibody titers and antibody-dependent cellular phagocytosis were higher in adults compared to pediatric COVID-19 patients. The neutralizing antibody titer correlated positively with age and negatively with IL-17A and IFN-γ serum concentrations. There were no differences in anti-spike protein antibody titers to other human coronaviruses. Together these findings demonstrate that the poor outcome in hospitalized adults with COVID-19 compared to children may not be attributable to a failure to generate adaptive immune responses.