Frontiers in Microbiology (Feb 2025)

Age-related immune response disparities between adults and children with severe COVID-19: a case–control study in China

  • Hongliang Chen,
  • Hongliang Chen,
  • Yuan Li,
  • Liping Yuan,
  • Fen Liu,
  • Qian Sun,
  • Qian Sun,
  • Qingkai Luo,
  • Yefei Lei,
  • Yinglan Hou,
  • Jiayan Li,
  • Liang Cai,
  • Shixing Tang

DOI
https://doi.org/10.3389/fmicb.2025.1525051
Journal volume & issue
Vol. 16

Abstract

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BackgroundElucidation of immune response differences is critical for uncovering underlying mechanisms and developing potential intervention measures among adults and children with COVID-19.MethodsIn this retrospective study, we analyzed serum biochemical markers and cytokine profiles among adults and children with COVID-19 in the First People’s Hospital of Chenzhou in Hunan, China from 1 December 2022 to 13 February 2023. A case–control study was conducted using propensity score matching (PSM) to mitigate possible confounding factors.ResultsThe significant differences observed included lymphocyte exhaustion, an increased neutrophil-to-lymphocyte (NEU/LYM) ratio, high levels of C-reactive protein (CRP), and a cytokine storm, characterized by high levels of Th1 proinflammatory cytokines, including interleukin 1β (IL-1β), IL-6, IL-8, interferon type I (IFN-γ), and tumor necrosis factor (TNF-α) in the lung among severe adult COVID-19 patients. Additionally, systemic immune responses were observed in children with COVID-19.ConclusionSignificant differences in immune responses between adults and children with COVID-19 highlight the different mechanisms and potential intervention measures of COVID-19.

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