31 May 2024 : Clinical Research
Differential Inflammatory Responses in Adult and Pediatric COVID-19 Patients: Implications for Long-Term Consequences and Anti-Inflammatory Treatment
Kacper Toczyłowski
1ACDEFG*, Dawid Lewandowski1AB, Diana Martonik 2BE, Anna Moniuszko-Malinowska 3ABE, Ewelina Kruszewska 3BE, Anna Parfieniuk-Kowerda 2BE, Robert Flisiak 2BE, Artur Sulik 1ABDE
DOI: 10.12659/MSM.944052
Med Sci Monit 2024; 30:e944052
Table 1 Characteristics of the study groups.
| Adults (n=22) | Children (n=13) | P | |
|---|---|---|---|
| Sex, females/males | 15/7 | 6/7 | 0.20 |
| Age, years | 54 (50–63) | 1 (0.4–2.0) | <0.001 |
| Comorbidities, any, n (%) | 15/22 (68%) | 0/13 (0%) | <0.001 |
| 1–2 comorbidities, n (%) | 10/22 (45%) | 0/13 (0%) | 0.004 |
| 3 or more, n (%) | 5/22 (23%) | 0/13 (0%) | 0.06 |
| Hypertension, n (%) | 8/22 (36%) | 0/13 (0%) | 0.01 |
| Dyslipidemia, n (%) | 6/22 (27%) | 0/13 (0%) | 0.04 |
| Diabetes, n (%) | 5/22 (23%) | 0/13 (0%) | 0.06 |
| Hypothyroidism, n (%) | 3/22 (14%) | 0/13 (0%) | 0.16 |
| Obesity, n (%) | 2/22 (9%) | 0/13 (0%) | 0.26 |
| Cancer survivor, n (%) | 2/22 (9%) | 0/13 (0%) | 0.26 |
| Epilepsy, n (%) | 2/22 (9%) | 0/13 (0%) | 0.26 |
| Asthma, n (%) | 1/22 (5%) | 0/13 (0%) | 0.44 |
| Kidney failure, n (%) | 1/22 (5%) | 0/13 (0%) | 0.44 |
| Adrenal gland insufficiency, n (%) | 1/22 (5%) | 0/13 (0%) | 0.44 |
| Cardiac arrhythmia, n (%) | 1/22 (5%) | 0/13 (0%) | 0.44 |
| Length of hospital stay, days | 12 (9–15) | 4 (4–5) | <0.001 |
| Symptoms | |||
| Fever, n (%) | 17/22 (77%) | 7/13 (54%) | 0.15 |
| Cough, n (%) | 19/22 (86%) | 9/13 (69%) | 0.22 |
| Malaise, n (%) | 17/22 (77%) | 4/13 (31%) | 0.007 |
| Chest pain, n (%) | 6/22 (27%) | 0/13 (0%) | 0.039 |
| Dyspnea, n (%) | 12/22 (54%) | 0/13 (0%) | 0.001 |
| Laboratory test results | |||
| CRP on admission, mg/L | 82.0 (7.2–140.8) | 0.5 (0.3–5.9) | <0.001 |
| CRP max, mg/L | 104.5 (10.0–145.6) | 0.5 (0.3–6.0) | <0.001 |
| CRP >80 mg/L on admission | 11/22 (50%) | 0/13 (0%) | 0.002 |
| CRP >80 mg/L anytime | 12/22 (54%) | 0/13 (0%) | 0.001 |
| Procalcitonin on admission, μg/L | 0.07 (0.03–0.30) | 0.05 (0.05–0.06) | 0.30 |
| Procalcitonin max, μg/L | 0.10 (0.06–0.30) | 0.06 (0.06–0.06) | 0.02 |
| WBC on admission, 10 cells/μL | 5.8 (4.6–8.9) | 8.9 (8.2–9.4) | 0.01 |
| WBC max, 10 cells/μL | 9.0 (7.6–10.7) | 9.6 (9.3–10.7) | 0.29 |
| Lymphopenia on admission, n (%) | 6/22 (27%) | 2/13 (15%) | 0.42 |
| Lymphopenia anytime, n (%) | 10/22 (45%) | 2/13 (15%) | 0.07 |
| Neutropenia on admission, n (%) | 0/22 (0%) | 1/13 (8%) | 0.19 |
| Neutropenia anytime, n (%) | 0/22 (0%) | 5/13 (38%) | 0.002 |
| ALT on admission, IU/L | 36 (28–62) | 16 (14–17) | <0.001 |
| ALT max, IU/L | 56 (40–75) | 18 (15–24) | <0.001 |
| D-dimers on admission, ng/mL | 699 (497–1172) | 343 (232–655) | 0.04 |
| D-dimers max, ng/mL | 1084 (993–1676) | 404 (203–944) | 0.003 |
| Treatment | |||
| ICU admission, n (%) | 1/22 (4%) | 0/13 (0%) | 0.43 |
| Oxygen mask, n (%) | 10/22 (45%) | 0/13 (0%) | 0.004 |
| Antibiotics, n (%) | 19/22 (86%) | 6/13 (46%) | 0.01 |
| Remdesivir, n (%) | 2/22 (9%) | 1/13 (8%) | 0.89 |
| Anti-inflammatory treatment (any), n (%) | 12/22 (54%) | 1/13 (8%) | 0.06 |
| Convalescent plasma, n (%) | 8/22 (36%) | 0/13 (0%) | 0.02 |
| Corticosteroids, n (%) | 10/22 (45%) | 1/13 (8%) | 0.02 |
| Tocilizumab, n (%) | 5/22 (28%) | 0/13 (0%) | 0.06 |
| Lymphopenia and neutropenia defined according to the age-dependent reference values. Continuous data presented as median and interquartile range, and compared using the Mann-Whitney U test. Categorical data are presented as frequencies and compared with the chi-squared test. | |||