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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.
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.
Abstract:
The biological mechanisms underlying long COVID in the pediatric population are poorly understood. Our study aimed to characterize the immune pathophysiology of long COVID in this population. We analyzed major immune cell compartments in PBMCs and the specific SARS-CoV-2 antibody response in 99 patients with long COVID and in 18 patients without long COVID at 3 months after acute infection. Our findings indicate that pediatric long COVID is associated with a dysregulated immune response characterized by altered innate immunity and overactivated T, B, and NK cell responses. Furthermore, young people with long COVID had an impaired humoral response to SARS-CoV-2 marked by a dysregulated B cell compartment and lower levels of anti-RBD IgG and IgA. This correlated with reduced neutralizing capacity against SARS-CoV-2. Random forest analysis identified CCR6 expression on myeloid cells as the most relevant biomarker that distinguishes individuals with long COVID from control individuals with 79% accuracy.
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