Cytokine Clusters and Immunity Profiles Associated With Disease Severity in Children With SARS-CoV-2 Infection

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Investigators conducted a study that compared serum cytokine concentrations and differences in immunity profiles in children hospitalized with SARS-CoV-2 infection.

The following article is a part of conference coverage from the IDWeek 2021, being held virtually from September 29 to October 3, 2021. The team at Infectious Disease Advisor will be reporting on the latest news and research conducted by leading experts in the field. Check back for more from the IDWeek 2021.

Among children with SARS-CoV-2 infection, assessing differences in immunity profiles and correlations between serum cytokine measurements and certain clinical parameters may help in the identification of potential biomarkers associated with COVID-19 disease severity, according to research presented at IDWeek, held virtually from September 29 to October 3, 2021.

Researchers conducted a study to identify differences in immunity associated with serum cytokine concentrations among a total of 133 children (aged 0-21 years) with SARS-CoV-Infection. All patients included in the study were recruited from a children’s hospital in Ohio, and SARS-CoV-2 infection and quantification was determined via nasopharyngeal swab with subsequent reverse-transcription polymerase chain reaction testing. In addition, the investigators used a 92-plex inflammation assay to measure serum cytokine concentrations, and patients normalized cytokine expression concentrations were compared against serum samples from 66 pre-pandemic age-matched healthy controls.

Among all patients with SARS-CoV-2 infection included in the study, 47 were identified via universal screening, 48 had moderate disease, 20 had severe disease, and 18 had multisystem inflammatory syndrome (MIS-C). Of patients enrolled via universal screening, trauma, appendicitis, and new onset diabetes were the most common causes of hospitalization.

In comparing clinical and laboratory results, as well as blood samples, the investigators noted that patients with symptomatic COVID-19 had significantly increased viral loads compared with those with MIS-C or those enrolled via universal screening. In addition, concentrations of interferon (IFN)-related cytokines (IFNg, CXCL9, CXCL10, CXCL11), interleukins (IL6, IL8, IL10, IL17A, IL18, IL24), and other inflammatory cytokines (TGF, TNF, VEGF, MCP, CD40) were found to be significantly increased in patients with acute SARS-CoV-2 infection and MIS-C vs those enrolled via universal screening and the healthy controls. Of the identified cytokines, the investigators noted a positive correlation with COVID-19 disease severity and patients C reactive protein and D-dimer concentrations; however, a negative correlation was observed in regard to SARS-CoV-2 viral loads.

A total of 3 cytokine clusters were identified in patients with SARS-CoV-2 infection via clinical presentations. “Correlations of serum cytokines with clinical/laboratory parameters could be used to identify potential biomarkers associated with disease severity in COVID-19,” the investigators concluded.

Disclosures: Some author(s) declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of disclosures.


Xu Z, Glowinski RM, Cohen SH, et al. Children with COVID-19 demonstrate distinct serum cytokines profiles according to clinical presentations. Presented at: IDWeek; September 29 to October 3, 2021. Poster 79.

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