Pediatric long COVID is characterized by myeloid CCR6 suppression and immune dysregulation

Jon Izquierdo-Pujol1,2,3, Núria Pedreño-Lopez1, Tetyana Pidkova1

  • 1IrsiCaixa, Badalona, Barcelona, Spain.

JCI Insight
|February 19, 2026
PubMed

Insights

Long COVID in children involves immune system dysregulation, including altered innate immunity and overactive T-, B-, and NK-cells. This immune imbalance impacts antibody response and neutralizing capacity against SARS-CoV-2.

Area of Science:

  • Immunology
  • Pediatrics
  • Infectious Diseases

Background:

  • Long COVID pathogenesis in pediatric populations remains largely unknown.
  • Understanding the immune system's role is crucial for diagnosing and treating pediatric long COVID.

Purpose of the Study:

  • To investigate the immune pathophysiology of long COVID in children and young people (CYP).
  • To identify immune biomarkers differentiating pediatric long COVID from controls.

Main Methods:

  • Analysis of peripheral blood mononuclear cells (PBMCs) and SARS-CoV-2 antibody responses in CYP with and without long COVID.
  • Utilized random forest analysis to identify predictive biomarkers.

Main Results:

  • Pediatric long COVID is linked to dysregulated innate immunity and hyperactive T-, B-, and NK-cell responses.
  • CYP with long COVID exhibited impaired humoral immunity, with dysregulated B-cells and lower anti-RBD IgG/IgA levels, correlating with reduced viral neutralization.
  • CCR6 expression on myeloid cells was identified as a key biomarker for long COVID in CYP with 79% accuracy.

Conclusions:

  • Pediatric long COVID is characterized by a distinct immune dysregulation.
  • Immune profiling and biomarker identification are essential for understanding and managing long COVID in children.

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