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Increased SARS-CoV-2 reactive low avidity T cells producing inflammatory cytokines in pediatric post-acute COVID-19 sequelae (PASC)
  • +14
  • Krystallenia Paniskaki,
  • Sarah Goretzki,
  • Moritz Anft,
  • Margarethe J. Konik,
  • Toni L. Meister,
  • Stephanie Pfaender,
  • Klara Lechtenberg,
  • Melanie Vogl,
  • Burcin Dogan,
  • Sebastian Dolff,
  • Timm H. Westhoff,
  • Hana Rohn,
  • Ursula Felderhoff-Mueser,
  • Ulrik Stervbo,
  • Oliver Witzke,
  • Christian Dohna-schwake,
  • Nina Babel
Krystallenia Paniskaki
Universitat Duisburg-Essen - Campus Essen

Corresponding Author:kpaniskaki@gmail.com

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Sarah Goretzki
Universitat Duisburg-Essen - Campus Essen
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Moritz Anft
Universitatsklinik Marien Hospital Herne
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Margarethe J. Konik
Universitat Duisburg-Essen - Campus Essen
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Toni L. Meister
Ruhr University Bochum
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Stephanie Pfaender
Ruhr University Bochum
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Klara Lechtenberg
Universitat Duisburg-Essen - Campus Essen
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Melanie Vogl
Universitat Duisburg-Essen - Campus Essen
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Burcin Dogan
Universitat Duisburg-Essen - Campus Essen
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Sebastian Dolff
Universitat Duisburg-Essen - Campus Essen
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Timm H. Westhoff
Marienhospital Herne Medizinische Klinik I Innere Medizin
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Hana Rohn
Universitat Duisburg-Essen - Campus Essen
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Ursula Felderhoff-Mueser
Universitat Duisburg-Essen - Campus Essen
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Ulrik Stervbo
Universitatsklinik Marien Hospital Herne
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Oliver Witzke
Universitat Duisburg-Essen - Campus Essen
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Christian Dohna-schwake
Universitat Duisburg-Essen - Campus Essen
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Nina Babel
Universitatsklinik Marien Hospital Herne
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Abstract

Background: A proportion of the convalescent SARS-CoV-2 pediatric population presents nonspecific symptoms, mental health problems and a reduction in quality of life similar to myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and long COVID-19 symptomatic. However, data regarding its clinical manifestation and immune mechanisms are currently scarce. Methods: In this study, we perform a comprehensive clinical and immunological profiling of 17 convalescent COVID-19 children with post-acute COVID-19 sequelae (PASC) manifestation and 13 convalescent children without PASC manifestation. A detailed medical history, blood and instrumental tests and physical examination were obtained from all patients. SARS-CoV-2 reactive T cell response was analyzed via multiparametric flowcytometry and the humoral immunity was addressed via pseudovirus neutralization and ELISA assay. Results: The most common PASC symptoms were shortness of breath/exercise intolerance, paresthesia, smell/taste disturbance, chest pain, dyspnea, headache and lack of concentration. Blood count and clinical chemistry showed no statistical differences among the study groups. We detected higher frequencies of spike (S) reactive CD4+ and CD8+ T cells among the PASC study group, characterized by TNFα and IFNγ production and low functional avidity. CRP levels are positively correlated with IFNγ producing reactive CD8+ T cells. Conclusions: Our data might indicate a possible involvement of a persistent cellular inflammatory response triggered by SARS-CoV-2 in the development of the observed sequelae in pediatric PASC. These results may have implications on future therapeutic and prevention strategies.
24 Jul 2023Submitted to Pediatric Allergy and Immunology
24 Jul 2023Submission Checks Completed
24 Jul 2023Assigned to Editor
24 Jul 2023Review(s) Completed, Editorial Evaluation Pending
27 Jul 2023Reviewer(s) Assigned
14 Aug 2023Editorial Decision: Revise Major
11 Nov 20231st Revision Received
16 Nov 2023Submission Checks Completed
16 Nov 2023Assigned to Editor
16 Nov 2023Review(s) Completed, Editorial Evaluation Pending
17 Nov 2023Reviewer(s) Assigned