Kovács Fanni, Posvai Tamás, Zsáry Eszter, Kolonics Ferenc, Garai Réka, Herczeg Vivien, Czárán Domonkos, Takács Johanna, Szabó Attila József, Krivácsy Péter, Csépányi-Kömi Roland
Pediatric Center, MTA Center of Excellence, Semmelweis University, Bókay Unit, Bókay János Street 53-54, 1083, Budapest, Hungary.
Department of Physiology, Semmelweis University, Budapest, Hungary.
Pediatr Res. 2024 Nov 27. doi: 10.1038/s41390-024-03731-1.
Many children suffer from lingering symptoms after COVID-19, known as long COVID syndrome (LCS), otherwise called Post COVID-19 Condition (PCC). Despite extensive research, the prevalence of symptoms, its impact on quality of life, and underlying mechanisms still need to be fully understood. As neutrophilic granulocytes play an essential role in COVID-19, and their prolonged disruption was found to cause immunological diseases, we hypothesized their ongoing disturbed functionality in LCS.
We studied 129 children with LCS, 32 convalescent children (CG+), and 8 uninfected children (CG-). Online questionnaires and in-person examinations assessed symptoms, quality of life, and functioning (QoL-F). Effector functions of neutrophilic granulocytes obtained from the venous blood of 29 LCS and 17 CG+ children were also investigated.
Persistent fatigue was the most common symptom in children with LCS, while both control groups complained about anxiety most frequently. LCS children experienced significantly more symptoms, impairing their QoL-F compared to CG+. Neutrophilic granulocyte dysfunction was found in LCS children, with decreased superoxide-producing activity and phagocytosis compared to CG+. The number of complaints of children with LCS correlated significantly with altered neutrophil effector functions.
Neutrophil dysfunction in children with LCS may be part of the disease pathogenesis or a predisposing factor.
Using online questionnaires validated during in-person medical examinations and including two different control groups, our study compellingly supports and adds to previous clinical observations in the field. Our study provides valuable insights into the prevalence and characteristics of pediatric LCS, highlighting the significant quality of life and functioning impairment compared to control groups. By detecting neutrophilic granulocyte dysfunction in children with LCS, we shed light on a previously overlooked pathophysiological component of the condition. We demonstrate a significant correlation between clinical symptoms and superoxide production, further enhancing our understanding of the underlying mechanisms of pediatric LCS.
许多儿童在感染新冠病毒后会出现持续症状，即所谓的新冠长期综合征（LCS），也被称为新冠后状况（PCC）。尽管进行了广泛研究，但症状的患病率、对生活质量的影响以及潜在机制仍有待充分了解。由于中性粒细胞在新冠病毒感染中起重要作用，且发现其长期紊乱会导致免疫疾病，我们推测它们在LCS中功能持续紊乱。
我们研究了129名患有LCS的儿童、32名康复期儿童（CG+）和8名未感染儿童（CG-）。通过在线问卷和现场检查评估症状、生活质量和功能（QoL-F）。还研究了从29名LCS儿童和17名CG+儿童的静脉血中获取的中性粒细胞的效应功能。
持续疲劳是LCS儿童最常见的症状，而两个对照组最常抱怨的是焦虑。与CG+相比，LCS儿童出现的症状明显更多，这损害了他们的QoL-F。在LCS儿童中发现了中性粒细胞功能障碍，与CG+相比，其超氧化物产生活性和吞噬作用降低。LCS儿童的症状主诉数量与中性粒细胞效应功能改变显著相关。
LCS儿童的中性粒细胞功能障碍可能是疾病发病机制的一部分或一个诱发因素。
通过在现场医学检查中验证的在线问卷，并纳入两个不同的对照组，我们的研究有力地支持并补充了该领域先前的临床观察结果。我们的研究为儿童LCS的患病率和特征提供了有价值的见解，突出了与对照组相比生活质量和功能的显著损害。通过检测LCS儿童的中性粒细胞功能障碍，我们揭示了该病症以前被忽视的病理生理成分。我们证明了临床症状与超氧化物产生之间存在显著相关性，进一步加深了我们对儿童LCS潜在机制的理解。
