Immunopathology of SARS-CoV-2 Infection: A Focus on T Regulatory and B Cell Responses in Children Compared with Adults

Gabriele Di Sante, Danilo Buonsenso, Cristina De Rose, Maria Tredicine, Ivana Palucci, Flavio De Maio, Chiara Camponeschi, Nicola Bonadia, Daniele Guerino Biasucci, Davide Pata, Antonio Chiaretti, Piero Valentini, Francesco Ria, Maurizio Sanguinetti, Michela Sali

Risultato della ricerca: Contributo in rivistaArticolo in rivista


While the clinical impact of COVID-19 on adults has been massive, the majority of children develop pauci-symptomatic or even asymptomatic infection and only a minority of the latter develop a fatal outcome. The reasons of such differences are not yet established. We examined cytokines in sera and Th and B cell subpopulations in peripheral blood mononuclear cells (PBMC) from 40 children (<18 years old), evaluating the impact of COVID-19 infection during the pandemic’s first waves. We correlated our results with clinical symptoms and compared them to samples obtained from 16 infected adults and 7 healthy controls. While IL6 levels were lower in SARS-CoV-2+ children as compared to adult patients, the expression of other pro-inflammatory cytokines such as IFNγ and TNFα directly correlated with early age infection and symptoms. Th and B cell subsets were modified during pediatric infection differently with respect to adult patients and controls and within the pediatric group based on age. Low levels of IgD− CD27+ memory B cells correlated with absent/mild symptoms. On the contrary, high levels of FoxP3+/CD25high T-Regs associated with a moderate–severe clinical course in the childhood. These T and B cells subsets did not associate with severity in infected adults, with children showing a predominant expansion of immature B lymphocytes and natural regulatory T cells. This study shows differences in immunopathology of SARS-CoV-2 infection in children compared with adults. Moreover, these data could provide information that can drive vaccination endpoints for children.
Lingua originaleEnglish
pagine (da-a)681-N/A
Stato di pubblicazionePubblicato - 2022


  • COVID-19 immunopathology
  • childhood SARS-CoV-2 infection


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