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Updated: Oct 13, 2025
Separation of Immune Cell Subpopulations in Peripheral Blood Samples from Children with Infectious Mononucleosis
Published on: September 7, 2022
Immunocompromised children and young people are at no increased risk of severe COVID-19
H Chappell1, R Patel2, C Driessens3
1NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Trust, Tremona Road, Southampton SO16 6YD, UK.
Insights
Immunocompromised children in the UK experienced SARS-CoV-2 infections, but without an increased risk of severe illness or death. This prospective study tracked 1527 pediatric patients from March 2020 to March 2021.
Area of Science:
- Pediatric Infectious Diseases
- Immunology
- Virology
Background:
- The incidence and clinical presentation of SARS-CoV-2 (COVID-19) in immunocompromised children are not well-defined.
- Understanding infection dynamics in this vulnerable population is crucial for public health strategies.
Purpose of the Study:
- To prospectively determine the incidence and clinical spectrum of SARS-CoV-2 infections in immunocompromised pediatric patients in the UK.
- To assess the risk of severe disease and mortality associated with COVID-19 in this cohort.
Main Methods:
- A prospective study involving 1527 immunocompromised children and adolescents across 46 UK hospitals from March 2020 to March 2021.
- Weekly questionnaires collected data on symptom presentation and SARS-CoV-2 Polymerase Chain Reaction (PCR) test results.
- Cross-sectional serology testing was performed in February and March 2021 on unvaccinated participants.
Main Results:
- 38 PCR-detected SARS-CoV-2 infections were reported between September 2020 and March 2021.
- Four children required hospitalization, but none experienced severe COVID-19; no deaths occurred.
- Antibody detection rates varied: 50% in those with prior positive PCR tests versus 7.4% in those without reported infection.
Conclusions:
- SARS-CoV-2 infections occurred in immunocompromised children and young people in the UK.
- These infections did not lead to an increased risk of severe disease or mortality in the studied cohort.
- The findings suggest that while infection is possible, severe outcomes are not more common in this group compared to the general pediatric population.
Objectives:
We aimed to prospectively describe the incidence and clinical spectrum of SARS-CoV-2 infection in immunocompromised paediatric patients in the UK.
Methods:
From March 2020 to 2021 weekly questionnaires were sent to immunocompromised paediatric patients or their parents. Information, including symptom presentation and SARS-CoV-2 PCR test results, was collected from 1527 participants from 46 hospitals. Cross-sectional serology was investigated in February and March 2021.
Results:
Until the end of September 2020, no cases were reported. From September 28th 2020 to March 2021 a total of 38 PCR-detected SARS-CoV-2 infections were reported. Of these, four children were admitted to hospital but none had acute severe COVID-19. Increasing age in association with immunodeficiency increased reporting of SARS-CoV-2 infection. Worsening of fever, cough, and sore throat were associated with participants reporting SARS-CoV-2 infection. Serology data included 452 unvaccinated participants. In those reporting prior positive SARS-CoV-2 PCR, there were detectable antibodies in 9 of 18 (50%). In those with no prior report of infection, antibodies were detected in 32 of 434 (7•4%).
Conclusions:
This study shows SARS-CoV-2 infections have occurred in immunocompromised children and young people with no increased risk of severe disease. No children died.
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