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Clinical, thyroid metabolic, and inflammatory features in pediatric patients with post-acute COVID-19

Ping Yin1, Dongqing Zhang1, Baomin Li1

  • 1Department of Pediatrics, Qilu Hospital of Shandong University, #107 West Wenhua Road, Jinan, Shandong, 250012, China.

BMC Infectious Diseases
|July 31, 2025
PubMed

Insights

Pediatric neuropsychiatric disorders post-COVID-19 (NP-COVID-19) are linked to low thyroid hormone (T3) syndrome and elevated cerebrospinal fluid (CSF) interleukin-8, not systemic inflammation.

Area of Science:

  • Pediatric neurology
  • Infectious diseases
  • Neuroimmunology

Background:

  • Children face increased risk of neuropsychiatric disorders after COVID-19.
  • Limited data exists on clinical, metabolic, and CSF profiles in pediatric NP-COVID-19.
  • This study investigated 13 pediatric patients with NP-COVID-19.

Purpose of the Study:

  • To describe clinical features of pediatric NP-COVID-19.
  • To assess metabolic and inflammatory profiles in NP-COVID-19 patients.
  • To compare NP-COVID-19 patients with healthy and migraine controls.

Main Methods:

  • Retrospective analysis of 13 pediatric NP-COVID-19 patients.
  • Comparison of metabolic and inflammatory markers with healthy children (HC) and pre-pandemic migraine patients.
  • Assessment of blood-brain barrier (BBB) integrity and CSF biomarkers.

Main Results:

  • No significant systemic inflammation or differences in inflammatory parameters between NP-COVID-19 patients and HC.
  • Elevated CSF interleukin-8 (IL-8) in NP-COVID-19 patients with intact BBB integrity compared to migraine controls.
  • Lower serum free triiodothyronine (FT3) levels in NP-COVID-19 patients, with low-T3 syndrome in 61.5%.

Conclusions:

  • Systemic inflammation is uncommon in pediatric NP-COVID-19.
  • Low-T3 syndrome is prevalent in pediatric NP-COVID-19.
  • Neuroinflammation in pediatric NP-COVID-19 is characterized by elevated CSF IL-8.
Abstract

Keywords:
COVID-19Low-T3 syndromeNeuropsychiatric symptomsPediatric patients

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