Körner Robert Walter, Bansemir Ole Yannick, Franke Rosa, Sturm Julius, Dafsari Hormos Salimi
Department of Pediatrics, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany.
Center for Rare Diseases, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany.
Children (Basel). 2023 Sep 25;10(10):1598. doi: 10.3390/children10101598.
SARS-CoV-2 infection causes transient cardiorespiratory and neurological disorders, and severe acute illness is rare among children. Post COVID-19 condition (PCC) may cause profound, persistent phenotypes with increasing prevalence. Its manifestation and risk factors remain elusive. In this monocentric study, we hypothesized that atopy, the tendency to produce an exaggerated immunoglobulin E (IgE) immune response, is a risk factor for the manifestation of pediatric PCC. We present a patient cohort (n = 28) from an early pandemic period (2021-2022) with comprehensive evaluations of phenotypes, pulmonary function, and molecular investigations. PCC predominantly affected adolescents and presented with fatigue, dyspnea, and post-exertional malaise. Sensitizations to aeroallergens were found in 93% of cases. We observed elevated IgE levels (mean 174.2 kU/L, reference < 100 kU/L) regardless of disease severity. Concurrent Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) was found in 29% of patients that also faced challenges in school attendance. ME/CFS manifestation was significantly associated with elevated immunoglobulin G subclasses IgG3 ( < 0.05) and IgG4 ( < 0.05). A total of 57% of patients showed self-limiting disease courses with mean recovery at 12.7 months (range 5-25 months), 29% at 19.2 months (range 12-30 months), and the rest demonstrated overall improvement. These findings offer additional insights into immune dysregulation as a risk factor for pediatric PCC.
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染会导致短暂的心肺和神经功能障碍，儿童中严重急性疾病较为罕见。新冠后状况（PCC）可能会导致严重、持续的表型，且患病率不断上升。其表现和危险因素仍不明确。在这项单中心研究中，我们假设特应性，即产生过度免疫球蛋白E（IgE）免疫反应的倾向，是儿童PCC表现的一个危险因素。我们展示了一个来自疫情早期（2021 - 2022年）的患者队列（n = 28），对其表型、肺功能和分子研究进行了全面评估。PCC主要影响青少年，表现为疲劳、呼吸困难和运动后不适。93%的病例发现对空气过敏原过敏。无论疾病严重程度如何，我们都观察到IgE水平升高（平均174.2 kU/L，参考值<100 kU/L）。29%的患者同时患有肌痛性脑脊髓炎/慢性疲劳综合征（ME/CFS），这些患者在上学出勤方面也面临挑战。ME/CFS的表现与免疫球蛋白G亚类IgG3（<0.05）和IgG4（<0.05）升高显著相关。共有57%的患者病程呈自限性，平均恢复时间为12.7个月（范围5 - 25个月），29%的患者为19.2个月（范围12 - 30个月），其余患者总体有所改善。这些发现为免疫失调作为儿童PCC的一个危险因素提供了更多见解。
