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Association between vaccinations and clinical manifestations in children with COVID-19

Shijian Liu1,2,3, Chunhui Yuan4, Jianfei Lin1,3

  • 1Child Health Advocacy Institute, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Translational Pediatrics
|February 26, 2021
PubMed

Insights

Pediatric COVID-19 infection rates are lower than in adults. This study found no significant difference in symptoms or outcomes between children vaccinated with Bacillus Calmette Guerin (BCG) and those unvaccinated, suggesting immune maturity influences severity.

Area of Science:

  • Pediatric Infectious Diseases
  • Immunology
  • Epidemiology

Background:

  • Coronavirus Disease 2019 (COVID-19) infection rates were observed to be lower in children compared to adults.
  • The underlying immunological or epidemiological reasons for this disparity remain largely unknown.
  • Understanding pediatric COVID-19 is crucial for public health strategies.

Purpose of the Study:

  • To investigate the association between initial symptoms and factors like age, Bacillus Calmette Guerin (BCG) vaccination, and influenza vaccination in pediatric COVID-19 cases.
  • To explore potential correlations between clinical manifestations and immune status in children diagnosed with COVID-19.
  • To contribute to the understanding of why children may experience different COVID-19 outcomes than adults.

Main Methods:

  • A case-control study involving 248 confirmed and 56 suspected pediatric COVID-19 cases from two hospitals in Wuhan and Shanghai.
  • Data collected included initial symptoms, age, Bacillus Calmette Guerin (BCG) vaccination status, and influenza vaccination status.
  • Statistical analyses, including Chi-square and t-tests, were used to determine associations between variables.

Main Results:

  • The study evaluated 248 confirmed and 56 suspected pediatric COVID-19 cases, with a median age of 6.82 years.
  • Approximately 30.26% of pediatric patients were asymptomatic. No significant difference in asymptomatic cases was found between those with and without BCG vaccination (P=0.203).
  • Initial symptoms were not significantly related to influenza vaccination status (P=0.267). Fever was associated with higher C-reactive protein (CRP) levels compared to afebrile patients (P<0.001).

Conclusions:

  • Bacillus Calmette Guerin (BCG) vaccination did not appear to alter clinical manifestations in pediatric COVID-19 patients.
  • The severity of symptoms in children with COVID-19 may be influenced by the maturity of their immune system.
  • Further research is warranted to elucidate the immunological factors contributing to differential COVID-19 susceptibility and severity in children.
Abstract

Keywords:
Bacillus Calmette Guerin (BCG)Coronavirus Disease 2019 (COVID-19)cytokinesimmunoglobulinspediatric cases

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