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A Case of Critically Ill Infant of Coronavirus Disease 2019 With Persistent Reduction of T Lymphocytes

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单位: [1]Huazhong Univ Sci & Technol, Tongji Hosp, Tongji Med Coll, Dept Pediat, 1095 Jiefang Ave, Wuhan 430030, Hubei, Peoples R China [2]Hubei Univ Med, Xiangyang 1 Peoples Hosp, Dept Pediat, Xiangyang, Hubei, Peoples R China [3]Huazhong Univ Sci & Technol, Tongji Hosp, Dept Infect Dis, Tongji Med Coll, Wuhan, Hubei, Peoples R China [4]Hubei Univ Med, Xiangyang 1 Peoples Hosp, Dept Publ Management, Xiangyang, Hubei, Peoples R China [5]Huazhong Univ Sci & Technol Wuhan, Tongji Med Coll, Sch Basic Med, Dept Pathogen Biol, Wuhan, Hubei, Peoples R China [6]Huazhong Univ Sci & Technol, Tongji Hosp, Tongji Med Coll, Dept Radiol, Wuhan, Hubei, Peoples R China [7]Huazhong Univ Sci & Technol, Tongji Hosp, Tongji Med Coll, Div Cardiol,Dept Internal Med, Wuhan, Hubei, Peoples R China [8]Hubei Univ Med, Xiangyang 1 Peoples Hosp, Dept Lab, Xiangyang, Hubei, Peoples R China [9]Hubei Univ Med, Xiangyang 1 Peoples Hosp, Dept Radiol, Xiangyang, Hubei, Peoples R China
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关键词: coronavirus disease 2019 infant critical case lymphopenia T cells

摘要:
Background: The outbreak of coronavirus disease 2019 (COVID-19) is becoming a global threat. However, our understanding of the clinical characteristics and treatment of critically ill pediatric patients and their ability of transmitting the coronavirus that causes COVID-19 still remains inadequate because only a handful pediatric cases of COVID-19 have been reported. Methods: Epidemiology, clinical characteristics, treatment, laboratory data and follow-up information and the treatment of critically ill infant were recorded. Results: The infant had life-threatening clinical features including high fever, septic shock, recurrent apnea, petechiae and acute kidney injury and persistent declined CD3+, CD4+ and CD8+ T cells. The duration of nasopharyngeal virus shedding lasted for 49 days even with the administration of lopinavir/ritonavir for 8 days. The CD3+, CD4+ and CD8+ T cells was partially recovered 68 days post onset of the disease. Accumulating of effector memory CD4+ T cells (CD4+TEM) was observed among T-cell compartment. The nucleic acid tests and serum antibody for the severe acute respiratory syndrome coronavirus 2 of the infant's mother who kept intimate contact with the infant were negative despite no strict personal protection. Conclusions: The persistent reduction of CD4+ and CD8+ T cells was the typical feature of critically ill infant with COVID-19. CD4+ and CD8+ T cells might play a key role in aggravating COVID-19 and predicts a more critical course in children. The prolonged nasopharyngeal virus shedding was related with the severity of respiratory injury. The transmission of SARS-CoV-2 from infant (even very critical cases) to adult might be unlikely.

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出版当年[2019]版:
大类 | 3 区 医学
小类 | 3 区 儿科 4 区 免疫学 4 区 传染病学
最新[2025]版:
大类 | 4 区 医学
小类 | 3 区 儿科 4 区 免疫学 4 区 传染病学
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出版当年[2018]版:
Q2 PEDIATRICS Q3 INFECTIOUS DISEASES Q4 IMMUNOLOGY
最新[2023]版:
Q1 PEDIATRICS Q2 INFECTIOUS DISEASES Q3 IMMUNOLOGY

影响因子: 最新[2023版] 最新五年平均 出版当年[2018版] 出版当年五年平均 出版前一年[2017版] 出版后一年[2019版]

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第一作者单位: [1]Huazhong Univ Sci & Technol, Tongji Hosp, Tongji Med Coll, Dept Pediat, 1095 Jiefang Ave, Wuhan 430030, Hubei, Peoples R China
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