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WAS IMMUNOGLOBULINS EFFECTIVE IN DISEASE SEVERITY AND LENGTH OF HOSPITAL STAY IN CHILDREN WITH THE INFECTION OF SARS-COV-2 ?

Year 2023, Volume: 24 Issue: 3, 322 - 326, 13.07.2023

Hatice Uygun Sibel Yavuz Nurettin Erdem Saniye Başak Oktay Mehmet Turğut

https://doi.org/10.18229/kocatepetip.1162663

Abstract

OBJECTIVE: We investigated whether immunoglobulin levels on admission are associated with disease severity, time to negativization of SARS-CoV-2 RT-PCR test, and length of hospital stay in children with severe illness requiring hospitalization.
MATERIAL AND METHODS: Forty-four pediatric patients hospitalized and treated for COVID-19 were included. The patients were divided into two groups as those with mild-to-moderate (n=35) and those with severe disease (n=9) for ease of evaluation. The relationship of immunoglobulin levels with disease severity, time to SARS-CoV-2 RT-PCR test negativization and length of hospital stay was examined.
RESULTS: The study population had a median (min-max) age of 13 (1-18) years and consisted of 25 (56.8%) girls and 19 (43.2%) boys. IgG levels were normal in 89.2% (n=33) and elevated in 5.7% (n=2) of the children with mild-to-moderate disease. Among patients with severe disease, IgG levels were normal in 44.4% (n=4) and elevated in 55.6% (n=5). A significant difference was found between the groups in terms of IgG levels (p=0.002). When the relationship of IgG level with length of hospital stay and time to SARS-CoV-2 RT-PCR test negativization was investigated, no significant correlation was observed between time to SARS-CoV-2 RT-PCR test negativization and Ig G level (p=0.096, z=1.667). However, the length of hospital stay was significantly longer in patients with elevated IgG levels (p=0.096, p=0.002).
CONCLUSIONS: Higher-than-normal endogenous IgG levels may be independently associated with the development of severe illness and prolonged hospital stay in children hospitalized for COVID-19.

Keywords

COVID-19 Children Immunoglobulins

References

  • 1. Panda PK, Sharawat IK, Natarajan V, et al. COVID-19 treatment in children: A systematic review and meta-analysis. J Family Med Prim Care. 2021;10(9):3292-3302.
  • 2. Schultze JL, Aschenbrenner AC. COVID-19 and the human innate immune system. Cell. 2021;184(7):1671-1692.
  • 3. Odales J, Guzman Valle J, Martínez-Cortés F, et al. Immunogenic properties of immunoglobulin superfamily members within complex biological networks. Cell Immunol. 2020;358:104235.
  • 4. Marcos-Jiménez A, Sánchez-Alonso S, Alcaraz-Serna A, et al. Deregulated cellular circuits driving immunoglobulins and complement consumption associate with the severity of COVID-19 patients. Eur J Immunol. 2021;51(3):634-647.
  • 5. Lotfi R, Kalmarzi RN, Roghani SA. A review on the immune responses against novel emerging coronavirus (SARS-CoV-2). Immunol Res. 2021;69(3):213-224.
  • 6. Husain-Syed F, Vadász I, Wilhelm J, et al. Immunoglobulin deficiency as an indicator of disease severity in patients with COVID-19. Am J Physiol Lung Cell Mol Physiol. 2021;320(4):590-599.
  • 7. Valentini P, Sodero G, Buonsenso D. The Relationship between COVID-19 and Innate Immunity in Children: A Review. Children (Basel). 2021;8(4):266.
  • 8. Zhao Y, Nie HX, Hu K, et al. Abnormal immunity of non-survivors with COVID-19: predictors for mortality. Infect Dis Poverty. 2020;9(1):108.
  • 9. Republic of Turkey Ministry of Health General Directorate of Public Health Covid-19 (SARS-CoV-2 Infection) Scientific Committee Study Pediatric Patient Management and Treatment Guide. January 2022, Ankara. Accessed February 25, 2022.
  • 10. Stanley, F. Reference intervals for laboratory tests and procedures. Nelson textbook of pediatrics. 20th ed. Philadelphia: Elsevier. 2015: 3465-72.
  • 11. Guan WJ, Ni ZY, Hu Y, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020;382(18):1708-1720.
  • 12. Qin C, Zhou L, Hu Z, et al. Dysregulation of Immune Response in Patients With Coronavirus 2019 (COVID-19) in Wuhan, China. Clin Infect Dis. 2020;71(15):762-768.
  • 13. Hasan Ali O, Bomze D, Risch L, et al. Severe Coronavirus Disease 2019 (COVID-19) is Associated With Elevated Serum Immunoglobulin (Ig) A and Antiphospholipid IgA Antibodies Clin Infect Dis. 2021;73(9):2869-74.
  • 14. Shields AM, Burns SO, Savic S, et al. UK PIN COVID-19 Consortium. COVID-19 in patients with primary and secondary immunodeficiency: The United Kingdom experience. J Allergy Clin Immunol. 2021;147(3):870- 875.
  • 15. Fletcher-Sandersjöö A, Bellander BM. Is COVID-19 associated thrombosis caused by overactivation of the complement cascade? A literature review. Thromb Res. 2020;194:36-41.
  • 16. Ni L, Ye F, Cheng ML, et al. Detection of SARS-CoV-2-Specific Humoral and Cellular Immunity in COVID-19 Convalescent Individuals. Immunity. 2020;52(6):971-977.
  • 17. Maecker HT. Immune profiling of COVID-19: preliminary findings and implications for the pandemic. J Immunother Cancer. 2021;9(5):e002550.
  • 18. Gustine JN, Jones D. Immunopathology of Hyperinflammation in COVID-19. Am J Pathol. 2021;191(1):4-17.

ÇOCUKLARDA SARS-COV-2 ENFEKSİYONUNDA İMMÜNOGLOBULİNLER HASTALIK ŞİDDETİ VE HASTANEDE YATIŞ SÜRESİNE ETKİLİ MİYDİ ?

Year 2023, Volume: 24 Issue: 3, 322 - 326, 13.07.2023

Hatice Uygun Sibel Yavuz Nurettin Erdem Saniye Başak Oktay Mehmet Turğut

https://doi.org/10.18229/kocatepetip.1162663

Abstract

AMAÇ: Hastaneye yatış gerektiren ciddi hastalığı olan çocuklarda başvuru sırasındaki immünoglobulin düzeylerinin hastalık şiddeti, SARS-CoV-2 RT-PCR testinin negatifleşmesine kadar geçen süre ve hastanede kalış süresi ile ilişkili olup olmadığını araştırdık.
GEREÇ VE YÖNTEM: Hastaneye yatırılan ve COVID-19 tedavisi gören kırk dört pediatrik hasta dahil edildi. Hastalar değerlendirme kolaylığı açısından hafif-orta (n=35) ve ağır hastalığı olanlar (n=9) olarak iki gruba ayrıldı. İmmünoglobulin düzeylerinin hastalık şiddeti, SARS-CoV-2 RT-PCR testi negatifleşmesine kadar geçen süre ve hastanede kalış süresi ile ilişkisi incelendi.
BULGULAR: Çalışma popülasyonunun ortanca (min-maks) yaşı 13 (1-18) olup, 25'i (%56,8) kız ve 19'u (%43,2) erkekten oluşmaktadır. Hafif-orta hastalığı olan çocukların %89.2'sinde (n=33) IgG seviyeleri normaldi ve %5.7'sinde (n=2) yükselmişti. Ağır hastalığı olan hastaların %44.4'ünde (n=4) IgG seviyeleri normaldi ve %55.6'sında (n=5) yükselmişti. IgG düzeyleri açısından gruplar arasında anlamlı fark bulundu (p=0,002). IgG düzeyinin hastanede kalış süresi ve SARS-CoV-2 RT-PCR testi negatifleşmesine kadar geçen süre ile ilişkisi incelendiğinde, SARS-CoV-2 RT-PCR test negatifleşmesine kadar geçen süre ile Ig G düzeyi arasında anlamlı bir ilişki gözlenmedi ( p=0.096, z=1.667). Ancak Ig G düzeyi yüksek olan hastalarda hastanede kalış süresi anlamlı olarak daha uzundu (p=0.096, p=0.002).
SONUÇ: Normalden yüksek endojen IgG seviyeleri, COVID-19 nedeniyle hastaneye yatırılan çocuklarda ciddi hastalık gelişimi ve uzun süreli hastanede kalış süresi ile bağımsız olarak ilişkili olabilir.

Keywords

COVID-19 Çocuk İmmünoglobulinler

References

  • 1. Panda PK, Sharawat IK, Natarajan V, et al. COVID-19 treatment in children: A systematic review and meta-analysis. J Family Med Prim Care. 2021;10(9):3292-3302.
  • 2. Schultze JL, Aschenbrenner AC. COVID-19 and the human innate immune system. Cell. 2021;184(7):1671-1692.
  • 3. Odales J, Guzman Valle J, Martínez-Cortés F, et al. Immunogenic properties of immunoglobulin superfamily members within complex biological networks. Cell Immunol. 2020;358:104235.
  • 4. Marcos-Jiménez A, Sánchez-Alonso S, Alcaraz-Serna A, et al. Deregulated cellular circuits driving immunoglobulins and complement consumption associate with the severity of COVID-19 patients. Eur J Immunol. 2021;51(3):634-647.
  • 5. Lotfi R, Kalmarzi RN, Roghani SA. A review on the immune responses against novel emerging coronavirus (SARS-CoV-2). Immunol Res. 2021;69(3):213-224.
  • 6. Husain-Syed F, Vadász I, Wilhelm J, et al. Immunoglobulin deficiency as an indicator of disease severity in patients with COVID-19. Am J Physiol Lung Cell Mol Physiol. 2021;320(4):590-599.
  • 7. Valentini P, Sodero G, Buonsenso D. The Relationship between COVID-19 and Innate Immunity in Children: A Review. Children (Basel). 2021;8(4):266.
  • 8. Zhao Y, Nie HX, Hu K, et al. Abnormal immunity of non-survivors with COVID-19: predictors for mortality. Infect Dis Poverty. 2020;9(1):108.
  • 9. Republic of Turkey Ministry of Health General Directorate of Public Health Covid-19 (SARS-CoV-2 Infection) Scientific Committee Study Pediatric Patient Management and Treatment Guide. January 2022, Ankara. Accessed February 25, 2022.
  • 10. Stanley, F. Reference intervals for laboratory tests and procedures. Nelson textbook of pediatrics. 20th ed. Philadelphia: Elsevier. 2015: 3465-72.
  • 11. Guan WJ, Ni ZY, Hu Y, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020;382(18):1708-1720.
  • 12. Qin C, Zhou L, Hu Z, et al. Dysregulation of Immune Response in Patients With Coronavirus 2019 (COVID-19) in Wuhan, China. Clin Infect Dis. 2020;71(15):762-768.
  • 13. Hasan Ali O, Bomze D, Risch L, et al. Severe Coronavirus Disease 2019 (COVID-19) is Associated With Elevated Serum Immunoglobulin (Ig) A and Antiphospholipid IgA Antibodies Clin Infect Dis. 2021;73(9):2869-74.
  • 14. Shields AM, Burns SO, Savic S, et al. UK PIN COVID-19 Consortium. COVID-19 in patients with primary and secondary immunodeficiency: The United Kingdom experience. J Allergy Clin Immunol. 2021;147(3):870- 875.
  • 15. Fletcher-Sandersjöö A, Bellander BM. Is COVID-19 associated thrombosis caused by overactivation of the complement cascade? A literature review. Thromb Res. 2020;194:36-41.
  • 16. Ni L, Ye F, Cheng ML, et al. Detection of SARS-CoV-2-Specific Humoral and Cellular Immunity in COVID-19 Convalescent Individuals. Immunity. 2020;52(6):971-977.
  • 17. Maecker HT. Immune profiling of COVID-19: preliminary findings and implications for the pandemic. J Immunother Cancer. 2021;9(5):e002550.
  • 18. Gustine JN, Jones D. Immunopathology of Hyperinflammation in COVID-19. Am J Pathol. 2021;191(1):4-17.
There are 18 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Articles
Authors

Hatice Uygun 0000-0002-8695-9129

Sibel Yavuz 0000-0002-6768-238X

Nurettin Erdem 0000-0003-4061-4675

Saniye Başak Oktay 0000-0002-3427-9893

Mehmet Turğut 0000-0002-2155-8113

Publication Date July 13, 2023
Acceptance Date October 17, 2022
Published in Issue Year 2023 Volume: 24 Issue: 3

Cite

APA Uygun, H., Yavuz, S., Erdem, N., Oktay, S. B., et al. (2023). WAS IMMUNOGLOBULINS EFFECTIVE IN DISEASE SEVERITY AND LENGTH OF HOSPITAL STAY IN CHILDREN WITH THE INFECTION OF SARS-COV-2 ?. Kocatepe Tıp Dergisi, 24(3), 322-326. https://doi.org/10.18229/kocatepetip.1162663
AMA Uygun H, Yavuz S, Erdem N, Oktay SB, Turğut M. WAS IMMUNOGLOBULINS EFFECTIVE IN DISEASE SEVERITY AND LENGTH OF HOSPITAL STAY IN CHILDREN WITH THE INFECTION OF SARS-COV-2 ?. KTD. July 2023;24(3):322-326. doi:10.18229/kocatepetip.1162663
Chicago Uygun, Hatice, Sibel Yavuz, Nurettin Erdem, Saniye Başak Oktay, and Mehmet Turğut. “WAS IMMUNOGLOBULINS EFFECTIVE IN DISEASE SEVERITY AND LENGTH OF HOSPITAL STAY IN CHILDREN WITH THE INFECTION OF SARS-COV-2 ?”. Kocatepe Tıp Dergisi 24, no. 3 (July 2023): 322-26. https://doi.org/10.18229/kocatepetip.1162663.
EndNote Uygun H, Yavuz S, Erdem N, Oktay SB, Turğut M (July 1, 2023) WAS IMMUNOGLOBULINS EFFECTIVE IN DISEASE SEVERITY AND LENGTH OF HOSPITAL STAY IN CHILDREN WITH THE INFECTION OF SARS-COV-2 ?. Kocatepe Tıp Dergisi 24 3 322–326.
IEEE H. Uygun, S. Yavuz, N. Erdem, S. B. Oktay, and M. Turğut, “WAS IMMUNOGLOBULINS EFFECTIVE IN DISEASE SEVERITY AND LENGTH OF HOSPITAL STAY IN CHILDREN WITH THE INFECTION OF SARS-COV-2 ?”, KTD, vol. 24, no. 3, pp. 322–326, 2023, doi: 10.18229/kocatepetip.1162663.
ISNAD Uygun, Hatice et al. “WAS IMMUNOGLOBULINS EFFECTIVE IN DISEASE SEVERITY AND LENGTH OF HOSPITAL STAY IN CHILDREN WITH THE INFECTION OF SARS-COV-2 ?”. Kocatepe Tıp Dergisi 24/3 (July 2023), 322-326. https://doi.org/10.18229/kocatepetip.1162663.
JAMA Uygun H, Yavuz S, Erdem N, Oktay SB, Turğut M. WAS IMMUNOGLOBULINS EFFECTIVE IN DISEASE SEVERITY AND LENGTH OF HOSPITAL STAY IN CHILDREN WITH THE INFECTION OF SARS-COV-2 ?. KTD. 2023;24:322–326.
MLA Uygun, Hatice et al. “WAS IMMUNOGLOBULINS EFFECTIVE IN DISEASE SEVERITY AND LENGTH OF HOSPITAL STAY IN CHILDREN WITH THE INFECTION OF SARS-COV-2 ?”. Kocatepe Tıp Dergisi, vol. 24, no. 3, 2023, pp. 322-6, doi:10.18229/kocatepetip.1162663.
Vancouver Uygun H, Yavuz S, Erdem N, Oktay SB, Turğut M. WAS IMMUNOGLOBULINS EFFECTIVE IN DISEASE SEVERITY AND LENGTH OF HOSPITAL STAY IN CHILDREN WITH THE INFECTION OF SARS-COV-2 ?. KTD. 2023;24(3):322-6.
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